Robotic surgery today is presented with challenges, including dealing with a non-perfect robot without haptic control, a steep learning curve, lack of established training criteria and high cost. Strategies such as structured, simulated training and novel anastomotic devices may potentially shorten the learning curve, improve patency and facilitate grafting in multi-vessel disease. Future challenges will include the ability to demonstrate long-term patency, morbidity and mortality at least comparable to conventional CABG, whilst also offering cost effectiveness in this increasingly difficult economic environment.