β-Lactam ring-containing compounds play a pivotal role in drug design and synthetic chemistry. Spirocyclic βlactams, representing an important β-lactam subclass, have recently attracted considerable interest with respect to new synthetic methodologies and pharmacological applications. The aim of this manuscript is to review the recent progress made in this field, covering publications disseminated between 2011 to 2018 concerning the synthesis and application of spirocyclic β-lactams. In the first part, new approaches to the synthesis of spirocyclic β-lactams, including Staudinger synthesis, cyclization and transformation reactions, will be presented. The reactivity and biological properties of spiro-β-lactams will be described in the second and third part, respectively.