This study evaluated short-term outcomes and costs of robotic-assisted vs conventional mitral valve repair in adults from 2016 to 2020 using data from the Nationwide Readmissions Database. Although robotic-assisted mitral valve repair had comparable risk-adjusted outcomes to conventional surgery, it was associated with higher median costs, except in high-volume programs where costs were similar. The findings suggest that while robotic approaches can be costly, their performance may be justified at centers of excellence in the United States.