The advantages of anterior, muscle-sparing interbody fusion for the management of degenerative scoliosis have been well defined in the literature. These include both direct and indirect decompression, restoration of disk/foraminal height and spinal biomechanics, correction of sagittal balance, and improved fusion rates. The continued evolution of minimally invasive techniques and surgical instrumentation has led to reduced morbidity for patients and increased popularity for anterior interbody techniques among surgeons. It is important to remember that when deciding on what interbody approach to use, the surgeon must consider goals of care, anatomic characteristics as seen on preoperative imaging, and surgical levels. Although each approach has distinct advantages and disadvantages, ultimately the most important deciding factor should lie with the surgeons’ experience and comfort levels with each approach.