Introduction: There is a paucity of data comparing remote magnetic navigation (RMN) to manual catheter navigation (MCN) in the ablation of accessory pathways (AP) in adult patients. Methods: A retrospective analysis of AP ablations performed in adults (>18 years old) at our institution was conducted from January 2015 to June 2020. Results: Over the five-and-a-half-year study period, there were 114 patients with a total of 132 APs ablated. Of the 114 patients, 14 required a second ablation and 2 required a third ablation. Of the 132 AP ablations, 114 were performed using MCN and 18 were performed using RMN. The mean age among all patients was 38.1 ± 14.5 years (p = 0.984) with 53.8% being male (p = 0.172). Mean follow up was 459.9 ± 435.4 days with no statistical difference between groups. The acute success of all ablations was 84.1% (111/132) with a significant difference in favor of the RMN group (100% vs 81.6%; p = 0.047). Number of lesions (RMN 12, IQR 5-17 vs MCN 7.5, IQR 3-13; p = 0.016), ablation time (RMN 368 sec, IQR 215-572 vs MCN 259 sec, IQR 133.5-461.25; p = 0.031), and procedure time (RMN 230.89 ± 79.42 vs MCN 183.26 ± 64.88; p = 0.006) as well as the cost per procedure (RMN $8,915 ± $2,552.11 vs MCN $6,675.35 ± $1,737.31; p = 0.001) were all significantly higher in the RMN group compared to the MCN group. Of the redo ablations, 100% (6/6) were successful using RMN while only 83.3% (10/12) were successful using MCN. Conclusion: Compared to manual navigation, remote magnetic navigation was more successful in first time and redo accessory pathway ablations. [ABSTRACT FROM AUTHOR]