Purpose of Review <p>Living donor nephrectomy is a cornerstone of kidney transplantation. Minimally invasive approaches offer reduced morbidity and faster recovery over open techniques. The purpose of this review is to elucidate recent advances and best practices in minimally invasive living donor nephrectomy procedures.</p> Recent Findings <p>Although robotic living donor nephrectomies have longer operative and warm ischemia times compared to the open and laparoscopic techniques, early and late graft function including graft survival are comparable in the open, robotic and laparoscopic groups. Enhanced recovery after surgery (ERAS) protocols are increasingly being used to improve perioperative outcomes.</p> Summary <p>This review focuses on the innovation of minimally invasive approaches to living donor nephrectomy over time and highlights the best practices during donor selection and the choice of surgical technique.</p>