Abstract: Objective To compare the clinical outcomes and costs of robot-assisted versus laparoscopic radical surgery for patients with gastric cancer. Methods Clinical data about 99 patients who underwent distal gastrectomy in Chinese PLA General Hospital from January 2016 to January 2017 were retrospectively analyzed. There were 41 cases in robot-assisted group (R group) and 58 cases in laparoscopic group (L group). Results There was no significant difference in length of incision, time to exhaust, time to liquid food intake, hospital stay, the number of harvested lymph node and postoperative complication rate between R group and L group (All P > 0.05). The operating time of R group was significant longer than that of L group (220.2±36.7) min vs (170.4±67.6) min, P < 0.000 1. However, the blood loss of R group was significantly less than that of L group (101.4±50.7) ml vs(138.1±73.9) ml, P< 0.05. Moreover, the costs of R group were higher than that of L group (11.11±2.76) ten thousand yuan vs(8.88±2.61) ten thousand yuan, P< 0.01. Conclusion Robot-assisted distal gastrectomy is safe and effective, and it has the same clinical effect as laparoscopic gastrectomy. However, the operating time and costs of robot-assisted gastrectomy show no advantage when compared with laparoscopic gastrectomy.