A methodology has been developed to compare different grid reinforcement solutions, ranging from conventional through hybrid to purely smart grid approaches. It evaluates alternative reinforcement solutions, subject to the constraints of the particular local network and situation. This methodology can be applied at all voltage levels and to both generic and actual networks. In the present study, it is applied to a representative medium voltage network of 4 feeders based on the IEEE 33-bus network. It focuses in particular on the implications of different reinforcement options on the expected annual level of network losses. The study concludes that the most effective reinforcement option depends on the anticipated load profile and growth in the location under consideration. It can be seen that energy losses have a significant impact on the choice of the most effective solution. It can also be seen that, under certain circumstances, a hybrid solution performs more effectively than either traditional reinforcement or pure smart grid solutions.