Traditionally, cardiac surgery has been performed by median sternotomy. However, a renaissance is occurring. Cardiac operations are being performed through smaller and alternative incisions with enhanced technological assistance. Both coronary artery bypass grafting and valve surgery can be accomplished with this novel methodology. Specifically, minimally invasive mitral valve surgery has become standard for many surgeons. At our institution, we have developed a robotic mitral surgery program with the da VinciTM telemanipulation system. This system allows the surgeon to perform complex mitral valve operations through small port sites rather than a traditional median sternotomy. Our techniques and initial results are reported, as is a brief overview of the evolution of robotic cardiac surgery.