Thanks to critical evaluation of clinical outcomes, long bone osteosynthesis techniques have constantly evolved from the original AO principle of Open Reduction and Internal Fixation (ORIF), which emphasized mechanical stability to a more biological approach to bone healing. This paradigm shift eventually led to a new philosophical approach known as Minimally Invasive Osteosynthesis or MIO. The success of MIO is in large part due to the implementation of new surgical approaches and to the development of angle stable implants, whether plates or interlocking nails. This presentation will describe MIPO and MINO indications and clinical outcomes as well as limitations and complications.