This study compares the clinical and economic outcomes of robot-assisted (R) and laparoscopic (L) approaches in bariatric surgeries for super-obese (BMI ≥ 50 kg/m²) and super-super-obese (BMI ≥ 60 kg/m²) patients. The study included 174 RYGB and 91 SADI-S procedures performed between 2012 and 2023. After propensity score matching, two groups of patients were identified: one for each surgical approach. The mean operative time was longer for robotic procedures (199.1 ± 65.7 min vs. 109.5 ± 39.1 min, p < 0.001). Post-operative complications and hospital stays were comparable between the two groups. Robotic surgeries were associated with higher costs (R-RYGB: €8134.6 ± 1886.7 vs. L-RYGB: €2386.7 ± 388.2; R-SADI-S: €7996.6 ± 873.1 vs. L-SADI-S: €3954.6 ± 631.1). Despite the higher costs, robotic surgery may offer advantages in complex cases such as super-super-obese patients. The study highlights the potential benefits of robotic technology in bariatric surgery, particularly for challenging cases, but also acknowledges the need for larger studies to draw definitive conclusions.This study compares the clinical and economic outcomes of robot-assisted (R) and laparoscopic (L) approaches in bariatric surgeries for super-obese (BMI ≥ 50 kg/m²) and super-super-obese (BMI ≥ 60 kg/m²) patients. The study included 174 RYGB and 91 SADI-S procedures performed between 2012 and 2023. After propensity score matching, two groups of patients were identified: one for each surgical approach. The mean operative time was longer for robotic procedures (199.1 ± 65.7 min vs. 109.5 ± 39.1 min, p < 0.001). Post-operative complications and hospital stays were comparable between the two groups. Robotic surgeries were associated with higher costs (R-RYGB: €8134.6 ± 1886.7 vs. L-RYGB: €2386.7 ± 388.2; R-SADI-S: €7996.6 ± 873.1 vs. L-SADI-S: €3954.6 ± 631.1). Despite the higher costs, robotic surgery may offer advantages in complex cases such as super-super-obese patients. The study highlights the potential benefits of robotic technology in bariatric surgery, particularly for challenging cases, but also acknowledges the need for larger studies to draw definitive conclusions.