Abstract – The medium voltage adjustable speed drives are a trend for high power applications. The products released in the last decade showed maturity of the technology and brought more confidence to use medium voltage converters in industry applications. Besides high power capability, some segments require optimized footprint for the machines installed inside the plant site. This factor is pushing the development of a branch of new voltage source converters, called Transformerless Voltage Source Drives. These converters bring the possibility to operate the system without phase shift transformers in the connection with the power supply. This paper discusses the well-known topologies applied to medium voltage high power converters, their characteristics, requirements and drawbacks of them. In addition, it is discussed the recent presented topologies applied to transformerless converters, with their challenges and recent developments, pointing a best understand of this new branch of converters.