It is Alcaraz’s eighth successive victory since his shock second-round defeat by Botic van de Zandschulp at the US Open. The four-time Grand Slam winner will play world number one and defending champion Jannik Sinner or Chinese wildcard Bu Yunchaokete for the title.
A tight first set saw the players fail to hold serve for four games in a row to leave it finely poised at 4-4.
Spaniard Alcaraz broke again in the 10th game before holding serve to take the first set in 48 minutes.
Medvedev needed two medical timeouts for treatment on his left leg as Alcaraz took control of the second set, sealing victory with his fourth match point.
“It was a little bit unusual, with serve being broken many times in the first set,” said Alcaraz. “I don’t know what happened to me. I probably lost focus a little bit.
“I’m really happy that I didn’t lose my focus too long in the first set. I recovered it as soon as I got broken, and I’m really happy that at the end of the set I was able to play really good tennis.” Elsewhere, Britain’s Dan Evans beat Alex Bolt of Australia 6-2 1-6 7-5 in the final round of qualifying for the Shanghai Masters. The world number 176, who is the only British player in the draw, will play Thiago Seyboth Wild of Brazil in the first round on Wednesday. Compatriot Jack Draper withdrew from the event on Monday because of an abdominal injury.
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