The central role of carbohydrates in medicinal chemistry has stimulated intensive research in the last few years to develop simpler and more efficient routes for their preparation. Among them, routes starting from simple and achiral building blocks have received particular attention considering their efficiency in terms of cost process and atom economy. Recent developments in the field of biocatalytic asymmetric aldol reactions have allowed the preparation of complex carbohydrate derivatives with high degrees of sophistication (up to five chiral centers). Starting from simple and achiral building blocks, such as dihydroxyacetone, glycolaldehyde, and formaldehyde, the reactions were found to proceed under complete stereocontrol. The aim of this review is to cover the most significant advances in the preparation of carbohydrate derivatives through asymmetric aldol reactions within the last five years. Selected examples include the preparation of rare natural d‐sugars such as d‐psicose, non‐natural l‐sugars and azasugars, as well as iminocyclitols or homo(iminocyclitols), C‐arylcarbohydrates, etc.