This article reviews the rationale, suggested benefits, and techniques of minimally invasive surgery (MIS) of the spine. While the efficacy and outcomes of open spinal decompression and fusion procedures have been validated in numerous longitudinal studies, these surgeries typically involve significant soft-tissue dissection and muscle retraction. MIS techniques aim to minimize iatrogenic damage to the soft tissues around the spine while allowing surgeons to perform effective decompression and fusion procedures. Here we summarize the rationale for the trend toward spinal MIS and highlight the more common procedures.