Abstract Robotic-assisted laparoscopic surgery (RALS) is making an increasingly significant contribution to the field of gynaecological surgery. RALS offers similar patient bene-fits to standard laparoscopic surgery (SLS) with a potentially more ergonomically friendly and less stressful environment for the surgeon. However, our understanding of how RALS may potentially reduce physiological stress on the surgeon is currently limited. To assess how performing surgical tasks using RALS in comparison to SLS impacts on hypothalamic pituitary adrenal (HPA) axis function and sympathetic nervous system (SNS) activity, two key indicators of the physiological stress response. This study is an analytical, within subjects, crossover design study. Sixteen surgically inexperienced medi-cal students performed tasks with both SLS and RALS instru-mentation. Blood pressure (BP) was taken before and after task performance. Skin conductance level (SCL), heart rate (HR) and HR variability (HRV) were measured continuously during task performance. Pre- and post-task saliva samples were col-lected to determine cortisol levels using ELISA. SCL was sig-nificantly lower during RALS in comparison to SLS task per-formance (p