125 Background: Surgical resection remains piviotal in the management of patients with esophageal cancer. Minimally invasive esophagectomy(MIE) has demonstrated superior operative outcomes compared to the open approaches. Robotic assistance has potential to further improve outcomes, however the long-term follow with this technique is lacking. Methods: Utilizing the National Cancer Database we identified patients who underwent esophagectomy and stratified by approach: open (OE), laparoscopic (LE) or robotic (RE). Baseline comparisons were made for continuous variables using both the Mann-Whitney U and Kruskal Wallis as appropriate. Pearson’s Chi-square test was used to compare categorical variables. Survival analysis was performed using the Kaplan-Meier method comparing survival curves with the log-rank test. All statistical tests were two-sided and α (type I) error < 0.05 was considered significant. Results: We identified 18,869 patients who underwent esophagectomy with a mean age of 65 ± 10 years. There were 10,882 (57.7%) OE, 7,102 (37.6%) LE, and 885 (4.6%) RE. There was no difference in T stage or N stage among groups. Thirty and 90-day mortality was 3.2% and 6.9% and was lower in the MIE groups compared to open 6.2% vs 7.9% p < 0.001. Median length of hospitalization in RE, LE and OE was comparable at 9, 10, and 10 days respectively, p = 0.06. Neoadjuvant therapy was administered in 9,118 (48.3%) patients and was more frequent in the RE 66.0% vs 57.5% OE vs LE 32% p < 0.001. Oncologic quality as indicated by R0 resections and median lymph node harvested were improved in patients undergoing RE: 836 (94.9%) and 16, LE: 5,322 (86.7%) and 4, and OE: 9,631 (91.1%) and 12, p < 0.001. The median and 5-year survival by approach: RE, LE and OE was 54.4 months and 47.7%, 55.6 months and 50.3%, and 47.4 months and 43.7%, p < 0.001. MVA demonstrated that age, location, neoadjuvant therapy, T-stage, N-stage, hospital volume, MIE, and R0 resections were predictive of survival. Conclusions: Short and long-term outcomes with robotic assisted esophagectomy demonstrates low mortality with superior R0 resections and lymph node harvest. Overall survival is benefited in patients undergoing MIE.