Alkaloids are one of the most diverse groups of secondary metabolites found in living organisms. The most economically important alkaloids are the bisindole vinblastine, and vincristine. Unraveling the complexity of the genetic, catalytic and transport processes of monoterpene indole alkaloids biosynthesis is one of the most stimulating intellectual challenges in the plant secondary metabolism field. More than 50 metabolic steps are required to synthesize the most important alkaloids in Catharanthus roseus. Until now about only 20 of the 50 enzymes required for their biosynthesis have been determined and characterized. Hence, there are still a number of important enzymes that need to be characterized, beginning with the isolation and cloning of genes. It is also of fundamental importance to elucidate the regulatory aspects of their biosynthesis, both at the cellular and the molecular level, in order to address the question of their function in the plants that are producing them. In this review, we present an analysis of the state of the art related to the biosynthesis of the monoterpene indole alkaloids.