This paper aims to determine the missed clinically significant prostate cancer (CSPC) rate for target and saturation biopsies using a robotic-assisted trans-perineal MRI-Fusion biopsy platform (TP MRI-Fusion BX) and the related complications. Mona Lisa was used for all the biopsy procedures. Robotic-assisted target and saturation biopsies had a miss rate of 2.97% CSPC. This was 2 to 3 times lower than doing target only and target plus systematic biopsy.