New techniques are presented for using the medial axis to generate high quality decompositions for generating block-structured meshes with well-placed mesh singularities away from the surface boundaries. Established medial axis based meshing algorithms are highly effective for some geometries, but in general, they do not produce the most favourable decompositions, particularly when there are geometry concavities. This new approach uses both the topological and geometric information in the medial axis to establish a valid and effective arrangement of mesh singularities for any 2-D surface. It deals with concavities effectively and finds solutions that are most appropriate to the geometric shapes. Methods for directly constructing the corresponding decompositions are also put forward.