The song is named after the city in Colombia, in which Maluma was born, and is a Latin pop track with elements of reggaeton and dance-pop.

"Medellín" received generally positive reviews from music critics, who called the song Madonna's best work in years, while noting an improvement from her previous two lead singles.

The accompanying music video was directed by Diana Kunst and Mau Morgó, and was released in April 2019 as part of a live MTV special.

In the sessions, they would bring food and sit around the table, and musicians would start playing instruments, singing fado and samba music.

"[12] Maluma then begins his part by singing in Spanish, asking Madonna to take a trip with him to Medellín, with him acting as her tour guide.

[14][16][9] Madonna also references Medellín's violent past from when it was the home base of narcoterrorist Pablo Escobar as she sings, "We built a cartel just for love/ Venus was hovering above us.

Rolling Stone's Jon Blistein deemed it "sultry and slinky", further commenting that the song "moves effortlessly between a sparse, understated verse and a brilliant chorus bursting with deep house euphoria".

[12] For Idolator, Mike Wass hailed it a "reggaeton-infused, oddball delight", and expressed the opinion that "the most pleasing thing [about 'Medellín'] is the core theme of letting go and taking chances".

[23] For Variety, Jem Aswad felt that while "Medellín" was not "the dancefloor-filling that fans might be hoping for, it's a sultry and promising introduction to Madonna's latest era".

[21] Sal Cinquemani from Slant Magazine compared the track to Madonna's 1987 single "La Isla Bonita", and highlighted her "sugary harmonies" that "balance out Maluma’s gigolo routine with a dreamy sweetness".

[13] Jaime Tabberer, from Gay Star News, opined that the song was "undeniably fresh", "relaxed" and "catchy", and a better lead single than "Living for Love" (2014) and "Give Me All Your Luvin'" (2012).

[25] Eve Barlow of Vulture noted that it was Madonna's best lead single since "Hung Up" (2005), while also viewing the song as an updated version of "La Isla Bonita".

Helligar also praised the sexual tension between Madonna and Maluma, adimitting that the singer "sounds as inviting as she did cooing about the tropical island breeze in 1987", with the last part being a reference to "La Isla Bonita".

[28] From The Guardian, Ben Beaumont-Thomas said that even though it lacks an "absolutely diamond pop chorus", the song has an "elegant, sinewy melody that twines around you rather than jabbing you into submission".

[31] According to Nicolas Hautman from Us Weekly, the song's "breezy and summery vibe almost make it feel like a subdued sequel to 'La Isla Bonita'".

Mapes explained that while it was "more sonically restrained" than some of Madonna's previous works, she still sounded like she was struggling to "find a balance between campy bangers and more mature balladry", and that it was Maluma who truly stood out, writing that "the chorus pops off into a joyous celebration because of him".

Concluding her review, Mapes referred to "Medellín" as "something of a sexy, stylish middle ground" for Madonna, but criticized the line "We built a cartel just for love" for being "cringe-y".

[70] In an interview with iHeartRadio's The Box, Madonna recalled that it was a "really fun video to make", explaining despite how "we worked 18 hours a day and it was freezing cold and I had to ride a horse at 6 o'clock in the morning with one eye, I had a ball".

[71] The music video starts off with Madonna praying in an empty church room about her struggles, as well as hope for the future of humanity.

More shots follow that show them in bed displaying affection, smoking and drinking champagne, as well as Madonna playfully sucking Maluma's toe.

[75] Kate Halfpenny of The New Daily complimented its "astonishing visuals" and noted that the horse scenes featured were reminiscent of soap opera Dynasty.

[77] According to Nylon's Allison Stubblebine, the video is "drenched in absolute excess and opulence", with Madonna "lounging in a formal gown alongside a silk-pajama-wearing Maluma" and "stomping down the dining table in a veiled cowboy hat to her new husband", and calling it "one hell of a party".

[78] Shakiel Mahjouri from Entertainment Tonight Canada called "Medellín" a "visually-stunning" music video in which Madonna "brings her rebellious spirit, using dance and song, into another dimension".

[82] Idolator's Wass also compared the opening scene with "Like a Prayer", and commented that the video was a "raised middle finger at ageists, misogynists and assorted other haters", as well as a "gorgeous work of art".

[84] The performance featured four virtual versions of her Madame X alter ego – a secret agent, a musician, a cha-cha instructor and a bride.

[85] Elements also present included a garden, rain and bursting blasts of color, provided by augmented reality, marking the first time it was used on American television.

[85] After being introduced by Kelly Clarkson, Madonna started the performance laying beneath a virtual garden, wearing a "pirate-like getup" and an eye-patch with an X, as well as "retro pin-curled wave[d]" hair.

[88][89][90] As Maluma appeared while wearing silky black button-down, the stage transformed into a patio restaurant, and they danced together on the tables as well as with the virtual versions of Madame X.

[89] During the performance, the singers recreated scenes from the song's music video, including Maluma removing a garter from Madonna's thigh.

[99] Madonna and Maluma performed the track along with her 2000 single "Music" during his Medallo en el mapa concert in Medellín, Colombia, on April 30, 2022.