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Purpose: Robotic-assisted proctectomy (RP) is increasingly being performed at select centers, however, data are still lacking regarding the outcomes of RP in inflammatory bowel disease (IBD). Rectal dissection in IBD patients is often technically difficult due to persistent inflammation, resulting in distorted anatomical planes and friable mesorectum. The purpose of this study was to determine whether the robotic-assisted approach, which provides technical advantages over laparoscopic proctectomy (LP), including improved 3-dimensional vision, increased dexterity, and precise tissue handling, would be beneficial in IBD patients. Methods: 17 consecutive RP (10 restorative with ileal pouch anal anastomosis (IPAA), 7 completion proctectomies) performed using da Vinci S system between 2009 and 2010, were case-matched to LP (10 IPAA, 7 completion) by age, gender, diagnosis (UC vs. Crohn’s disease), body-mass index (BMI), type of proctectomy, and preoperative use of anti-TNF medications. Retrospective analysis compared peri- and post-operative outcomes. A subset of patients receiving IPAA was evaluated for postoperative functional outcomes and quality of life (QOL). Results: Operative time was longer in the RP group (p=.01), while estimated blood loss was similar (344 mL in RP and 189 mL in LP, p=.07). Even though time to return of bowel function was similar, 3.4 days in RP and 2.2 days in LP (p=.06), the length of hospital stay was longer in RP vs. LP (7.7 vs. 5.3 days, p=.02). There was no difference in post-operative complications between the two groups, including anastomotic leak, wound infection, postoperative ileus, and bowel obstruction. Patients receiving IPAA (6 RP, 8 LP) reported similar functional outcomes with regard to mean number of daily bowel movements (6 RP vs. 7.3 LP). There was a trend towards decreased frequency of perianal pruritis in the RP group compared to LP. The IPAA groups reported similar improvement in QOL, satisfaction with procedure and recommendation of the procedure to others. Conclusion: This study reports the results of our initial series of consecutive RP compared to LP in IBD patients. While RP operative times and length of hospital stay were longer than LP, short-term outcomes including complications were similar between the groups. In a subset of RP patients undergoing IPAA, pouch functional outcomes were similar or slightly better compared to LP IPAA group. As experience accumulates we expect RP operative times and length of stay to approach those of LP. Larger studies will be required to further evaluate the role of RP for patients with IBD.