This paper discusses the procedure for the determination of the optimum leakage inductance of a medium frequency transformer (MFT) for a quasi-two-level (Q2L) operating three-phase modular multilevel converter dual-active bridge (MMC-DAB) considering the effects of the MFT winding configuration. Three different winding configurations-namely, Y-Y, D-D, and Y-D-are considered for the connection of the MFT windings. The optimum leakage inductance requirement of the MFT, the currents total harmonic distortion (THD), and the transformer utilization factor (TUF) are compared for the three winding configurations. It is found that the Y-Y and the D-D configurations have similar optimum leakage inductance patterns, which are different from the Y-D configuration. Furthermore, it is established that an optimized leakage inductance value for a conventional DAB, can be utilized for the Q2L-operating MMC-DAB for a wide range of transition time with the Y-Y and the D-D winding configurations if less than a 5% error could be tolerated in its value. A comparison with respect to the TUF and the currents THD revealed that the Y-Y and the D-D configurations result in a higher TUF compared to the Y-D configuration; However, the Y-D configuration has approximately two times lower currents THD compared to the other two configurations