Minimal access spinal technologies aim primarily at minimizing the trauma associated with surgical exposure of the spine. They owe their existence mainly to recent progress in optical and imaging devices and to the development of instrumentations specifically designed for insertion via minimally invasive approaches. No published scientific studies have proved that minimally invasive techniques are superior over standard techniques. However, patients benefit from the decreased postoperative pain, shorter hospital stay, and expedited return to normal activities. Finally, minimal access spinal technologies are evolving at a fast pace. Progress is being made in defining the indications, and assessable results have been obtained for a number of lesions. This article describes the main techniques and highlights the beneficial effects on patient comfort.