Urology has been on the forefront of technological advances in minimally invasive surgery,from laparoscopy to robot-assisted surgeries.As with all new technological advances in medicine,the results of new advances are compared to previously established gold standards.When it comes to robot-assisted urology,morbidity,oncological outcomes,and cost between the same surgeries performed in an open fashion vs with robot-assistance should be assessed.Because healthcare spending is increasingly under more scrutiny,there is debate on the cost effectiveness of robot-assisted surgeries given the high acquisition and maintenance cost of robotic systems.This articles aims to critically evaluate the cost effectiveness of robot-assisted surgeries for prostatectomies,cystectomies,and partial nephrectomies in the United States.