US Open runner-up Medvedev, chasing his fourth ATP Tour title in a breakthrough 2019 season, will meet Germany's Alexander Zverev in Sunday's final.
Rafael Nadal showed no signs of rust as he raced into a 5-0 lead against fellow Spaniard Roberto Bautista Agut in the first set on Court Rainier III, defending his Monte Carlo Masters title with 6-1, 6-1.
Angelique Kerber and Alexander Zverev both won their singles matches against Spain to give Germany a winning start to their Hopman Cup campaign.
Alexander Zverev claimed the biggest title of his career with a 6-4, 6-3 upset on Sunday, becoming the youngest champion of the season-ending event since Djokovic claimed the first of his five titles a decade ago — also at age 21.
Stefano Tsitsipas downed Wimbldon finalist Kevin Anderson in three sets to set up a meeting on his 20th birthday with Rafael Nadal,
As the Spaniard overcame Marin Cilic it was the Greek teen Stefanos Tsitsipas who was the talking point after he defeated defending champion Alexander Zverev in three sets.
The 21-year-old German won his third title of the year and the ninth of his career by defeating Australian teen Alex De Minaur 6-2, 6-4 in the 50th edition of the US Open tuneup event.
The carnage of seeds at the world's premier grass court tennis tournament continued, with only one of the top 10 women's seeds remaining in the tournament at the fourth round.
Alexander Zverev overcame Russian in five sets while Austrian Dominic Thiem downed Japan's Kei Nishikori in four sets.
While Nadal dropped a set to win the mens titles, Elina Svitolina defended the women's title, scorching through to her title in a mere 67 minutes.
Nadal, still unbeaten in semi-finals at the Foro Italico, unleashed a trademark clay-court attack after winning a tight first set lasting well over an hour in the 51st clash between the two players.
Nadal fought back from two sets down and saved four match points in a 135-minute minute fifth set in which he successfully served to stay alive nine times, but it was not enough.
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