Cardiovascular surgery has come a long way from median sternotomies and hypothermic conditioning to procedures needing only 3 cm. Cardiac surgery in Colombia evolved alongside North America and Europe in many aspects concerning technological advancements to improve patient care. 1–3 Considering the developing nature of Colombia, cardiothoracic surgery lagged behind for some years until a wave of younger surgeons looked to adopt the minimally invasive horizons in cardiovascular surgery. In this paper we present Colombia’s evolution with regard to minimally invasive cardiovascular surgical (MICS) approaches and visions for the future. In the 1950s, there were no cardiac surgery residency programs in Colombia and surgeons seeking cardiovascular surgery training would go abroad to acquire training. Upon returning in the late 1950s, cardiac surgery centers began functioning in the country. 1–3 Many of these “first” cardiac surgeons in Colombia were trained in the United Kingdom and the United States. Some of the first reports of cardiovascular surgical procedures in Colombia date back to 1958 in Medellín under hypothermia at the Cardio VID Clinic and the first epicardial pacemaker placement at the Fundación Clínica Shaio in Bogota. 1–3 The first records of thoracoscopic approaches were in Bogota during the early 1980s in the form of medical thoracoscopy (pleuroscopy) for tuberculosis patients. 1–3 Continuous training through traveling remained a standard for keeping upto-date with newer techniques. However, up until 1990, all cardiac surgical procedures were performed through median sternotomy.