The problem of optimal siting and dimensioning of photovoltaic (PV) generators in medium-voltage distribution networks is addressed in this research from the perspective of combinatorial optimization. The exact mixed-integer programming (MINLP) model is solved using a master–slave (MS) optimization approach. In the master stage, the generalized normal distribution optimization (GNDO) with a discrete–continuous codification is used to represent the locations and sizes of the PV generators. In the slave stage, the generalization of the backward/forward power method, known as the successive approximation power flow method, is adopted. Numerical simulations in the IEEE 33-bus and 69-bus systems demonstrated that the GNDO approach is the most efficient method for solving the exact MINLP model, as it obtained better results than the genetic algorithm, vortex-search algorithm, Newton-metaheuristic optimizer, and exact solution using the General Algebraic Modeling System (GAMS) software with the BONMIN solver. Simulations showed that, on average, the proposed MS optimizer reduced the total annual operative costs by approximately 27% for both test feeders when compared with the reference case. In addition, variations in renewable generation availability showed that from 30% ahead, positive reductions with respect to the reference case were obtained.