The various syntheses of the over-the-counter anti-obesity drug tetrahydrolipstatin (also known as Orlistat) are reviewed. The 31 various syntheses cover the development of enantioselective natural products synthesis since the first synthesis of tetrahydrolipstatin (THL) by Schneider in 1987. After Schneider'sl andmark synthetic effort there have been numeroust otal and formal syntheses of THL, which have involvedadiverse range of approaches. These various syntheses can be classified by the methodst hat were used to install the stereochemistry,f or instance, chiral auxiliary,a symmetrica ldol, asymmetric allylation/crotylation, asymmetricr eductions,a symmetricr esolutions, asymmetric oxidations, and chiron approach. These routes also feature the elegant use of ac hiral phosphate template, at andem [2+ +2]-Mukaiyama aldol-lactonization, an anti-aldol segment via an on-aldol route, aP rins cyclization,a nd an epoxide carbonylation.