Objective To evaluate the clinical efficacy of salvage robot-assisted laparoscopic pyeloplasty for recurrent ureteropelvic junction obstruction (UPJO) and summarize the surgical experience. Methods From Aug. 2015 to Jul. 2018, 27 patients with recurrent UPJO received salvage robot-assisted laparoscopic pyeloplasty in the Department of Urology, the First Medical Center of PLA General Hospital. There were 20 males and 7 females with a median age of 31 years (range, 12-63 years). Among them, 26 patients failed in the primary pyeloplasty and one patient had a history of secondary pyeloplasty. The perioperative data were recorded. Ultrasound and urine routine examination were done postoperatively during follow-up, and computed tomography urography or emission computed tomography was performed when necessary. Results All operations were successfully completed without converting to open surgery. The operation time was 105-360 min (mean [159.7±54.2] min), estimated blood loss was 10-100 mL (mean [36.3±20.2] mL), the time of catheter indwelling was 2-10 d (mean [4.2±2.4] d), the time of drainage tube indwelling was 3-7 d (mean [4.7±1.8] d), and the postoperative hospitalization time was 3-12 d (mean [4.4±2.9] d). Double-J ureteral catheters were removed 8 weeks postoperatively. The follow-up time was 12-36 months (mean [21.2±9.8] months). The hydronephrosis was relieved or disappeared in 26 cases and renal function was recovered to varying degrees, which reached the criterion of surgical cure. The thickness of renal parenchyma decreased in one case without any relief of obstruction, and ureteroscopy showed a narrow ring at the anastomotic site, which was relieved after the double-J ureteral catheter was placed, and the catheter was finally removed after 2 months. Conclusion Salvage robot-assisted laparoscopic pyeloplasty is a safe and feasible procedure for recurrent UPJO, with low incidence of complications and satisfactory results in ameliorating hydronephrosis and renal function. Robot-assisted laparoscopic pyeloplasty is recommended for recurrent UPJO when the corresponding facility and technique are available.