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Because of their unique mechanical properties and biocompatibility, shape memory alloys (SMAs) have found many applications in minimally invasive surgery (MIS). Many novel surgical devices have been developed based on SMAs, which have become essential tools for MIS. In this paper, the historical development of SMAs for MIS is reviewed, including devices for cardiovascular surgery, laparoscopic and endoscopic surgery, orthopaedic surgery and other minimally invasive procedures. Current trends of the SMAs technologies are identified and future directions are discussed with research opportunities of SMAs for the emerging minimally invasive or noninvasive surgical technologies.