Reconstruction of perineal defects has long relied on the rectus abdominis flap. While traditionally approached though an external incision, the morbid nature of this incision and violation of the anterior rectus sheath has led to the development of a variety of minimally invasive approaches for harvest. Evolution of the technique at our institution reflects our belief that an external incision with skin paddle can be avoided in almost all cases when laparotomy is avoided, including cases where vaginal wall defects must be reconstructed. Demonstrating these principles and the surgical technique for harvest of a robotic rectus abdominis muscle (RRAM) muscle flap for vaginal wall reconstruction is a 67-year-old female who has a history of T2N0 adenocarcinoma or the rectum. She previously had a robotic low anterior resection with coloanal pull through and hand sewn anastomosis with distal negative margins. She was found to have a positive distal uptake on PET CT eleven months post-operatively with confirmed recurrent adenocarcinoma with invasion of the posterior vaginal wall after flexible sigmoidoscopy and biopsy. A coordinated effort between the colorectal and plastic surgery teams resulted in a total robotic completion abdominoperineal resection and posterior vaginectomy with intraabdominal levator transection and subsequent robotic rectus abdominis flap reconstruction, utilizing the posterior rectus fascia and peritoneum to recreate the posterior vaginal wall. The resulting abdominal fascial defect was simultaneously repaired robotically utilizing porcine biologic mesh to reduce the patient's risk of hernia or bulge following muscle harvest.