The development of new pharmaceutical compounds is challenging because most of them are based on enantiopure chiral molecules, which exhibit unique properties for therapy. However, the synthesis of pharmaceutical compounds in the absence of a chiral environment naturally leads to a racemic mixture. Thus, to control their synthesis, an asymmetric environment is required, and chiral homogeneous catalysts are typically used to synthesize enantiopure pharmaceutical compounds (EPC). Nevertheless, homogeneous catalysts are difficult to recover after the reaction, generating additional problems and costs in practical processes. Thus, the development of chiral heterogeneous catalysts is a timely topic. In a more general context, such chiral materials cannot only be used for synthesis, but also to recognize and separate enantiomers. In the frame of these different challenges, we give in this review a short introduction to strategies to extrinsically and intrinsically modify heterogeneous metal matrixes for the enantioselective synthesis, recognition, and separation of chiral pharmaceutical compounds.