This review provides an overview of the field of minimally invasive surgery and computer-assisted surgery for total knee arthroplasty. The authors have examined the complete body of literature for scientific evidence supporting the use of these new technologies and how the literature specifically supports commonly asked questions. There is controversy concerning the benefits of minimally invasive surgery and computer-assisted surgery for total knee arthroplasty. However, in most studies the results are similar for minimally invasive surgery compared to standard approaches. Computer-assisted navigation has been found in some studies to improve radiographic alignment of total knee arthroplasty. The authors believe that there is evidence for both technologies to be at least equivalent in terms of results, as well as expectations of increased success with the techniques. Both technologies have led manufacturers to invest more effort into newer prosthetic instrumentations and designs to facilitate these techniques.