Natural aminoglycosides are therapeutically useful antibiotics and very efficient RNA ligands. They are oligosaccharides that contain several ammonium groups able to interfere with the translation process in prokaryotesu pon binding to bacterial ribosomal RNA (rRNA), and thus, impairing protein synthesis. Even if aminoglycosides are commonly used in therapy,t hese RNA bindersl ack selectivity and are able to bind to aw ide number of RNA sequences/structures. This is one of the reasons for their toxicitya nd limited applications in therapy.A tt he same time, the ability of aminoglycosides to bind to various RNAs renders them ag reat source of inspirationf or the synthesis of new bindersw ith improved affinity and specificity toward several therapeutically relevant RNA targets. Thus, an umber of studies have been performed on these complex and highly functionalized compounds, leading to the development of various synthetic methodologies toward the synthesis of conjugated aminoglycosides. The aim of this review is to highlight recent progress in the field of aminoglycoside conjugation,p aying particulara ttention to modificationsp erformed toward the improvement of affinity and especiallyt ot he selectivity of the resulting compounds. This will help readers to understand how to introduce ad esired chemical modification for future developments of RNA ligandsa sa ntibiotics, antiviral, and anticancer compounds.