El Clásico Paisa

The first time the two clubs met was during the 1948 Campeonato Profesional on 12 September 1948, a 3–0 victory by Independiente Medellín.

In the first nine editions, Atlético Nacional (called Atlético Municipal during that time) could not beat Independiente Medellín, and it was not until 1954 that Nacional got their first win in the derby, winning 1–0. On 4 July 1959, Nacional defeated Medellín 7–2, the most goals they have scored on Medellín in a single match. In 1976 Nacional beat Medellín 6–0, the largest margin of victory in the rivalry. In 1994, Nacional claimed their sixth league title by defeating their crosstown rivals 1–0 on the final round of the final quadrangular with a late goal by Juan Pablo Ángel. Five years later, a similar situation happened again; Nacional beat Medellín 1–0 in the Torneo Finalización finals with a late goal and qualified for the season's grand final where they defeated América de Cali. However, Medellín got their revenge by winning four derbies from 2000 to 2001, including a 4–0 victory on 18 February 2001.

In 2004, Medellín and Nacional qualified for the Torneo Apertura finals by winning their respective semi-final groups. In the first leg, Medellín won 2–1 with goals from Rafael Castillo and Jorge Serna. The second leg, played on 27 June 2004, ended in a 0–0 draw, thus giving the red-clad club its third title and second in three years. Starting from that day, the next seven derbies were won by Nacional, including a 4–0 victory on 19 March 2005. It took Medellín 30 months after winning the 2004 title for them to beat Nacional again, breaking that streak with a 1–0 win on 4 November 2006.

On 5 August 2009, Medellín beat Nacional 2–0 at that year's Copa Colombia. Medellín went on an unbeaten run in the next six matches, until Nacional defeated them 1–0 on 12 September 2010 in the Torneo Finalización.

On 27 June 2011, exactly seven years after the 2004 Apertura final, Medellín thrashed Nacional 5–1 in a match valid for the 2011 Copa Colombia.

In the 2015 Torneo Finalización, the two sides faced each other in one of the tournament's double-legged semi-finals. The first leg played on 10 December, was won by Medellín 1–0. In the second leg Nacional bounced back from this adverse score, winning 2–0 and qualifying to the finals, which they later won to claim their 15th title.

On 3 December 2023, Medellín beat Nacional 5–0, with Nacional being the home team. The match was played at the Estadio Polideportivo Sur in Envigado due to a Karol G concert at Estadio Atanasio Girardot, and this score became Medellín's greatest margin of victory over Nacional. The match had to be ended early due to protests of Nacional fans who were causing disturbances.

Shows of support by fans of both teams

Atlético Nacional is one of the most supported clubs in the country, with a large percentage of their supporters coming from other parts of the country. Whilst Independiente Medellín does not have as much support, it is well supported throughout the city, especially in the comunas, which is why it is often referred to as "El Equipo del Pueblo" (the people's team).^[4] Their fans are characterized as very loyal, due to the long trophy droughts the club has been through, and they usually create large tifos before derby matches.^[5][6][7]

Independiente Medellín is usually one of the clubs with the most ticket sales in the league.^[8] In 2022, despite not being a "big" club with lots of history and success, it had more ticket sales than other more popular clubs such as América de Cali and Millonarios and only falling short to their crosstown rivals Nacional.^[9][10] A study revealing the 50 South American clubs with the highest attendance between 2009-2019 had Medellin 19th in South America and second in Colombia behind Nacional.^[11]