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More than 170 countries have already established renewable energy targets to meet their national increasing energy demand and also to keep their environment sustainable. Due to a number of features, the use of the multi-megawatt solar photovoltaic (PV) power plants is becoming the preferred choice for escalating and updating the power systems all over the world. Moreover, the solar PV power plant is also the first choice for meeting rapidly growing demands; as it can be installed relatively quickly, say in 6–12 months, compared to that of the fossil-fuel-based plants that may require more than 4–5 years. The traditional low-voltage (288–690 V) converter-based system requires a step-up transformer and a line filter to interconnect a solar PV power plant with medium-voltage grids. Recently, the use of medium-voltage converters without a step-up transformer and a line filter has become more attractive for direct medium-voltage grid integration of solar PV power plants. This paper aims to review the necessity and the technical challenges in developing medium-voltage power electronic converters, including the converter circuit topologies and control techniques used in the development of medium-voltage converters to interconnect solar PV power plants to medium-voltage grids directly. In this paper, a comprehensive review of the current research activities and the possible future directions of research to develop medium-voltage converter technologies to provide for a cost-effective grid integration of solar PV power plants are presented. [ABSTRACT FROM AUTHOR]