This chapter focuses on chemical reactions occurring within solid organic inclusion compounds, encompassing a broad range of inclusion compounds and a wide variety of different reaction types, including reactions of the guest molecules (such as dimerization, polymerization, cyclization, isomerization, and decomposition), reactions involving the host molecules, and guest exchange processes. In many cases, chemical transformations of guest molecules confined within solid host structures proceed with a high degree of selectivity toward a single product, and often with a high degree of stereoselectivity and/or enantioselectivity, as a consequence of the geometrical constraints imposed on the reacting molecules by the host structure. For this reason, the products obtained from such reactions are often significantly different from those obtained from the corresponding reactions in the solution state or in the “pure” crystalline phase of the guest molecules. Through the examples highlighted in this chapter, general issues relating to reactions in solid organic inclusion compounds are rationalized and discussed.