A systematic review of ultrasound-guided robotic surgical procedures was conducted to assess the applications and future potential of intraoperative ultrasound (IOUS) in robotic surgery. The review included 20 studies, with the majority focusing on general surgery, particularly liver, pancreas, spleen, gallbladder, vascular, and rectal surgery. Other studies covered oncological surgery, including urology, lung surgery, and retroperitoneal lymphadenectomy. Key applications of RIOUS included locating tumoral lesions, defining resection margins, assessing the feasibility of robotic ultrasound-guided surgery, comparing robotic and laparoscopic ultrasound probes, evaluating robotic drop-in probes, and visualizing blood flow in the splenic artery. The review highlights the advantages of robotic instrumentation, such as ergonomics, dexterity, and precision, which are particularly relevant for robotic intraoperative ultrasound (RIOUS). RIOUS offers benefits such as improved surgical precision, reduced physical strain on surgeons, and enhanced visualization of anatomical structures. It has shown promise in various surgical fields, including hepatobiliary surgery, where it aids in comprehensive anatomical assessment. RIOUS also provides real-time, non-invasive imaging, which is beneficial for oncological surgery, particularly in identifying and managing tumors. However, the integration of RIOUS remains underused due to cost considerations, lack of expertise, and the need for highly skilled minimally invasive surgeons trained in both robotics and ultrasound techniques. The review emphasizes the importance of further research, including large-scale randomized controlled trials, to demonstrate the utility of RIOUS in assessing oncological outcomes. The study concludes that RIOUS has the potential to support intraoperative decision-making and reduce minimally invasive procedure times.A systematic review of ultrasound-guided robotic surgical procedures was conducted to assess the applications and future potential of intraoperative ultrasound (IOUS) in robotic surgery. The review included 20 studies, with the majority focusing on general surgery, particularly liver, pancreas, spleen, gallbladder, vascular, and rectal surgery. Other studies covered oncological surgery, including urology, lung surgery, and retroperitoneal lymphadenectomy. Key applications of RIOUS included locating tumoral lesions, defining resection margins, assessing the feasibility of robotic ultrasound-guided surgery, comparing robotic and laparoscopic ultrasound probes, evaluating robotic drop-in probes, and visualizing blood flow in the splenic artery. The review highlights the advantages of robotic instrumentation, such as ergonomics, dexterity, and precision, which are particularly relevant for robotic intraoperative ultrasound (RIOUS). RIOUS offers benefits such as improved surgical precision, reduced physical strain on surgeons, and enhanced visualization of anatomical structures. It has shown promise in various surgical fields, including hepatobiliary surgery, where it aids in comprehensive anatomical assessment. RIOUS also provides real-time, non-invasive imaging, which is beneficial for oncological surgery, particularly in identifying and managing tumors. However, the integration of RIOUS remains underused due to cost considerations, lack of expertise, and the need for highly skilled minimally invasive surgeons trained in both robotics and ultrasound techniques. The review emphasizes the importance of further research, including large-scale randomized controlled trials, to demonstrate the utility of RIOUS in assessing oncological outcomes. The study concludes that RIOUS has the potential to support intraoperative decision-making and reduce minimally invasive procedure times.