Different structural chemistries resulting from the Pb2+ lone-pair electrons in the PbMO3 perovskites are reviewed. The Pb2+ lone-pair electrons enhance the ferroelectric transition temperature in PbTiO3, stabilize vanadyl formation in PbVO3, and induce a disproportionation reaction of CrIV in PbCrO3. A Pb2+ + NiIV = Pb4+ + NiII reaction in PbNiO3 stabilizes the LiNbO3 structure at ambient pressure, but an A-site Pb4+ in an orthorhombic perovskite PbNiO3 is stabilized at modest pressures at room temperature. In PbMnO3, a ferroelectric displacement due to the lone pair electron effect is minimized by the spin–spin exchange interaction and the strong octahedral site preference of the MnIV/III cation. PbRuO3 is converted under pressure from the defective pyrochlore to the orthorhombic (Pbnm) perovskite structure where Pb–Ru interactions via a common O −2p orbital stabilize at low temperature a metallic Imma phase at ambient pressure. Above Pc
a covalent Pb–Ru bond is formed by Pb2+ + RuIV = Pb4+ + RuII electron sharing.