OBJECTIVE: To compare functional and surgical outcomes of robot-assisted ileal ureter replacement (RAIUR) vs robot-assisted kidney autotransplantation (RAKAT). PATIENTS AND METHODS: This was a retrospective analysis of patients who underwent RAIUR or RAKAT for long ureteric strictures at eight European tertiary centres (2017-2024). Primary endpoints were maintenance of estimated glomerular filtration rate (eGFR) and postoperative complications within 30 days of surgery, described using the Clavien-Dindo classification. Secondary outcomes included infections, need for lifelong drainage, stricture persistence, and re-intervention for the stricture during follow-up. RESULTS: A total of 15 and 39 patients underwent RAIUR and RAKAT, respectively. The patients who underwent RAIUR were older (61 vs 45 years, P = 0.03), with more comorbidities (Charlson Comorbidity Index ≥3: 67% vs 28%, P = 0.03) and had a lower baseline eGFR (60 vs 87 mL/min/1.73m CONCLUSION: In the first comparative analysis of RAIUR and RAKAT, we provide evidence that both techniques provide similar improvements in renal function and similar rates of postoperative high-grade complications. Both approaches represent definitive solutions for ureteric strictures in most patients. The choice of the technique should be based on patients' factors, patients' expectations and the surgeon's experience.