Three-level active neutral-point-clamped (NPC) (ANPC) (3L-ANPC) voltage-source converters (3L-ANPC VSCs) offer three additional switch states and an increase of commutations by a factor of four, compared to the three-level NPC voltage-source converter. This paper presents, for the first time, a detailed analysis of all 3L-ANPC VSC commutations using high-power 5SHY55L4500 integrated gate-commutated thyristors. Starting with a description of the switching states and commutations, a new 3-kV 5-kA medium-voltage 3L-ANPC testbench is described. To verify the function of all commutations, this paper derives suitable switching sequences and analyzes the commutations and switching transients in detail for dc-link voltages of 2.13–2.43 kV and load currents of 3.95–4.36 kA. The experimental investigations show that, although the ANPC commutations substantially differ from NPC commutations, the ANPC commutations do not present critical operating conditions for the power semiconductors or the converters. Thus, all 32 ANPC commutations can be applied in a new medium-voltage converter realization.