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This paper presents a general comparison procedure for medium voltage - high power multilevel converter topologies and semiconductors, which is mainly based on analyzing the performance limits of the converters output characteristics such as the output voltage, current, active power, efficiency, etc. Afterwards, the general procedure is applied to compare some of the most relevant converter topologies oriented to a 6.6 kV drive application supplying quadratic torque loads and using 4.5 kV IGBT modules. The paper concludes evaluating the comparison factors of the different converter topologies and selected semiconductors obtained by the proposed procedure. The proposed procedure can potentially be extrapolated to any desired application framework.