Minimal invasive extracorporeal circulation (MiECC) was proposed in the 1990s to reduce various types of adverse complications caused by cardiopulmonary bypass (CPB) as much as possible. This paper reviews the development of MiECC and current studies in different types of cardiac surgeries. At present, plenty of studies can prove the MiECC system is able to preserve coagulation system, reduce blood loss and control the release of inflammatory factors, and helpful in protecting multiple organs to improve prognosis, shorten the length of hospitalization stay and reduce the postoperative mortality. However, the MiECC system shows different outcomes in different types of surgeries.