Background: The extended totally extraperitoneal technique (eTEP) is a novel approach for ventral hernia repair. This technique has been recently advanced using robotics (r-eTEP). The aim of this study is to perform a comprehensive analysis of the initial results of r-eTEP and to evaluate the safety and efficacy of this technique compared to the eTEP technique. Methods: This is a monocentric retrospective study of patients with ventral hernias who underwent surgery via eTEP or r-eTEP in our department between 2019 and 2023. Propensity score matching was applied to compare the groups. Preoperative patient and hernia characteristics, intraoperative findings, and postoperative outcomes were subsequently analysed. Results: Patient demographics were comparable between the groups. The r-eTEP group had a significantly greater proportion of M3 hernias ( p = 0.006), M4 hernias ( p = 0.020), incisional hernias ( p = 0.002), and hernias with rectus diastasis ( p < 0.001). The r-eTEP group had a significantly larger hernia defect ( p = 0.003) and larger mesh size ( p = 0.015). The r-eTEP group had a shorter hospital stay ( p < 0.001) and shorter operative time, though not statistically significant ( p = 0.211). Intraoperative and postoperative complications, as well as postoperative pain, were comparable between the groups. Conclusion: The findings of the present study show that the r-eTEP technique may offer potential benefits as the overall hospital stay was shorter while intraoperative and postoperative complications were comparable for both techniques.