A 72 year old female with a history of Class I obesity, hypertension, impaired glucose tolerance and prior midline laparotomy for sigmoid diverticulitis presented with a symptomatic midline incisional hernia. Her abdominal wall bulging had been increasing over time, and she had no obstructive symptoms. On exam she had a reducible midline hernia defect below the umbilicus along her previous laparotomy incision. CT scan confirmed clinical exam, demonstrating a moderate-sized midline hernia defect. Surgical options including open, laparoscopic, and robotic repairs were each discussed with the patient, and she elected to proceed with robotic abdominal wall reconstruction utilizing enhanced-view, totally extraperitoneal (eTEP) access. The patient was taken to the operating room for robotic abdominal wall reconstruction (AWR). She was found to have an 8 cm by 9 cm midline hernia. Restoration of the linea alba was achieved, and there were no intraoperative complications. The entire rectus sheath extending from xiphoid to pubis was reinforced with polypropylene mesh, measuring 26 cm vertically, by 20 cm horizontally. Utilizing eTEP access, the procedure was achieved without entering the peritoneal cavity. The procedure duration was 178 minutes. Intraoperative TAP block was performed for adjuvant pain control. Following surgery she was taken to the post-anesthesia recovery unit in stable condition and with well-controlled pain. She was discharged after a short recovery period. At postoperative follow-up, she has suffered from no surgical site infection or surgical site occurrence. She has no evidence of a recurrent hernia.