Complex forefoot deformities are challenging to treat and are labor intensive for the surgeon and the patient. New minimally invasive surgery (MIS) shows great potential and in some instances outperforms traditional open surgery. Another advantage MIS has is that it is technically easier to perform (once proficient) and produces less pain and recovery for the patient. This article takes the reader through MIS preoperative planning, soft tissue considerations, the different osteotomy configuration options, rationale, transverse plane correction, sagittal plane correction, revision MIS surgery of malunions, metatarsus adductus correction, hybrid MIS correction, and postoperative bandaging and management.