Background Robotic microsurgery has been proposed to enhance precision, ergonomics, and accessibility in microsurgical practice. Claimed benefits include tremor elimination, improved dexterity, simulation-based training, and reduced physical strain on surgeons. However, adoption of robotic platforms in other surgical specialties has produced variable results. Given the substantial cost and learning curve, the role of robotic microsurgery remains debated. This review examines the current evidence supporting robotic microsurgery and its potential advantages and limitations. Methods A literature review of the published evidence on robotic microsurgery was performed. Evidence relating to clinical performance, training, ergonomics, operative efficiency, and cost was reviewed. Consultation with experienced microsurgeons and industry representatives was undertaken. Results Reported advantages of robotic microsurgery include tremor filtration, enhanced instrument stability, improved surgeon ergonomics, and opportunities for simulation-based training. These features may broaden access to microsurgical techniques. Reported limitations include increased operative time during early adoption, a significant learning curve, high capital and maintenance costs, and reduced versatility in complex operative environments, such as surgery adjacent to fixation hardware. Concerns regarding potential deskilling in conventional microsurgical techniques have also been raised. Conclusion Robotic microsurgery represents a promising technological development with potential benefits for both patients and surgeons. However, current evidence remains limited and heterogeneous. Further clinical and cost-effectiveness studies are required before widespread adoption can be recommended.