Purpose - The purpose of this paper is to present a methodology for medical robot kinematics design developed using a knowledge-management approach. Design/methodology/approach - A classification of medical robots is proposed based on their kinematic characteristics and 76 robot specifications were collected in a catalogue. Then, having drawn a generic specifications sheet, rules were proposed to choose a structure from these specifications. Findings - Findings are situated at several levels: the catalogue, the classification of robots with respect to their kinematic characteristics, a generic and specific specifications sheet, and an organigram to choose the most relevant structure from the specifications. Research limitations/implications - This structural synthesis represents a preliminary step in the design of medical robots which will be completed by an additional dimensional synthesis. Originality/value - This work offers a new methodology for medical robots design distinct from what is usually done for medical or industrial robots design using intuition, expertise and non-formal knowledge.