For many people abroad, the word "Medellín" still carries one image: the cocaine trade of the 1980s and the violence that came with it. That image is decades old. It is also, by almost every measure available today, out of date. This article looks at what actually changed, what the numbers say, and why so many international visitors now describe Medellín as one of South America's most welcoming cities.
General information only. This article is not a substitute for individualized safety, travel or medical advice.
The old story: where the reputation comes from
In the 1980s and early 1990s, Medellín was the center of the Pablo Escobar era. Drug trafficking, cartel violence and bombing campaigns gave the city a reputation that traveled around the world — and outlived the era that created it. The history is real. The label, however, describes a city that no longer exists in that form.
What actually changed
Over three decades, Medellín rebuilt itself around public investment and urban innovation. The Metro was expanded and connected to the hillside neighborhoods by cable-car lines. Library parks were built in districts the city had neglected for years. Comuna 13 — once one of the most dangerous neighborhoods in Colombia — gained public escalators and later became famous for its street art and tours. The transformation was physical, social and civic at the same time.
The results were recognized internationally: in 2013, Medellín was named "Innovative City of the Year" by The Wall Street Journal and Citi, in partnership with the Urban Land Institute — ahead of cities like New York and Tel Aviv.
The crime story, in plain terms
Violence in Colombia peaked in the early 1990s and then fell year after year. Forbes travel coverage of Colombia's tourism boom notes that crime statistics "continued to drop from their astonishing peaks in the early 1990s" even as travel to the country accelerated.
Source: Forbes, June 2025.
Visitors are voting with their feet
The clearest evidence of the shift is the number of people now choosing to come. In 2025, Medellín set a tourism record: nearly 2.1 million visitors passed through José María Córdova International Airport, of whom about 1.2 million were foreign visitors not resident in Colombia — an increase of roughly 11% over 2024.
Sources: Portafolio, 2026; El Colombiano, 2026.
The city's own tourism intelligence system reported that in the first half of 2025 alone, Medellín received 954,632 visitors — about 59% of them international — and that the city surpassed Cartagena in international arrivals for the first time, making it Colombia's second city for international visitors behind Bogotá. The United States was the largest single market, with more than 310,000 travelers in 2025.
Sources: Caracol Radio, 2025; Alcaldía de Medellín, 2026.
International recognition keeps coming
In late 2025, National Geographic named Medellín among its "Best of the World 2026" destinations, citing the city's thriving creative and cultural scene — recognition Forbes described as part of the city's growing appeal with international visitors. The same coverage highlighted Medellín's standing as the "City of Eternal Spring," a reference to its mild year-round climate at 1,500 meters above sea level, with daytime temperatures typically in the low-to-mid 20s Celsius.
Source: Forbes, October 2025.
Culture, diversity and food
Medellín today is a city people visit for its life, not despite it. The Museo de Antioquia holds one of the largest collections of Fernando Botero's work, whose oversized bronze sculptures fill the plazas downtown. The Feria de las Flowers fills each August with parades, orchids and concerts. Comuna 13's graffiti tours tell the city's own story in its residents' words. And the food scene runs from traditional paisa dishes — bandeja paisa, arepas, sancocho — to a growing set of modern restaurants, specialty coffee shops and international kitchens.
The city is also more diverse than its stereotype suggests. People from every region of Colombia have made Medellín home, and the city hosts growing communities of North Americans, Europeans and Latin Americans who have chosen to live, work and build businesses there.
A growing international community
Medellín has become one of Latin America's most popular cities for expatriates, retirees and remote workers. Neighborhoods such as El Poblado and Laureles have well-established international communities, with English commonly spoken in restaurants, cafés, gyms and coworking spaces, and active groups for newcomers from the United States, Canada and Europe. For international patients and families, that matters in practical terms: English-language services, international schools and familiar retail are part of daily life in much of the city.
Connectivity supports that community. José María Córdova International Airport offers direct flights to more than two dozen cities in about 14 countries, including several in the United States.
An honest picture
No large city is without risk, and Medellín is no exception. Petty theft exists, as it does in most major cities, and normal travel precautions apply: keep valuables secure, use registered transportation, and stay aware of your surroundings. What has changed is the scale and character of the risk. The city that international rankings, airline routes and record visitor numbers now describe is not the city of the 1980s — and the people who know it today, from residents to the more than a million foreign visitors a year, consistently describe a city that feels open, welcoming and alive.
Why this matters when choosing treatment abroad
A city's character is one factor among many. Clinical fit, medical standards, continuity of care and family logistics matter far more than scenery or reputation. If you are evaluating the Medellín region as a place for residential treatment, our companion guide covers what to weigh — healthcare access, connectivity, environment and the limits of medical-tourism logic.
Read next: Why the Medellín region is being considered for treatment · Why Colombia.
Frequently asked questions
Is Medellín safe for visitors today?
Millions of visitors travel to Medellín each year, and its tourism numbers keep setting records. Like in any large city, petty theft exists and ordinary precautions apply. The level of cartel-era violence that defined the city's old reputation is part of a past decade, not the present one.
Wasn't Medellín one of the most dangerous cities in the world?
In the 1980s and early 1990s, yes — that period defined its international image. Decades of sustained investment, urban innovation and social programs have transformed it, and international media including Forbes and National Geographic now cover the city as one of the world's rising destinations.
Do people speak English in Medellín?
Spanish is the everyday language, but English is widely spoken in the neighborhoods most visited by internationals, such as El Poblado and Laureles, and in restaurants, coworking spaces and clinics that serve international patients.
Why is Medellín popular with expats?
A mild year-round climate, direct international flights, a lower cost of living than many U.S. or European cities, established international neighborhoods and a welcoming culture have made it a leading destination for remote workers, retirees and families.