The advent of minimally invasive surgery (MIS) has allowed patients to undergo highly effective spinal procedures while minimizing pain and extended recovery time associated with more traditional “open” techniques. MIS brings with it a host of unique challenges including limited access, reduced direct visualization of key anatomic structures, and a confined working space. Technological advances in surgical navigation afford surgeons improved visualization and spatial orientation in both pre-surgical planning and the operating room. Integration of navigation technology with MIS techniques can allow for greater surgical precision and confidence while further simplifying the recovery process and minimizing disruption to patients’ lives. Such technology has been successfully incorporated into a number of spinal procedures including lumbar fusion and decompression. Looking ahead, advanced navigation and robotic assistance are likely to be increasingly implemented for more complex cases including tumor resection and extensive spinal deformity. This special issue provides an assessment of the current state of the art for minimally invasive surgery and an overview of exciting possibilities for the future integration of spinal navigation.