Positron emission tomography (PET) is a unique non-invasive imaging tool for studying in vivo biological processes. It utilizes short-lived positron emitter labeled organic molecules to study biological events in real-time. To incorporate the positron emitter into a molecule of biological interest, radioactive synthons are developed to facilitate radiolabeling chemistry. In addition to 11 C-methylation with [ 11 C]CH 3 I/[ 11 C]CH 3 OTf, 11 Ccarbonylation with [ 11 C]CO, and 11 C-carboxylation of organometallic reagents with [ 11 C]CO 2 , 11 C-cyanation with [ 11 C]HCN is another frequently used 11 C-labeling methodology. It can lead to the generation of [ 11 C]organo-nitriles, [carbonyl-11 C] carboxylic acids, [carbonyl-11 C]aldehydes, [carbonyl-11 C]amides, [ 11 C]alkyl amines, [tetrazoyl-11 C]tetrazoles, [ 11 C]CN-containing heterocycles, etc. This review recognizes the important roles of 11 C-cyanation reactions with the emphasis of recent advances, along with the discussion of molar activities (A m ) of [ 11 C]HCN based radiotracers and prompts for future potential [ 11 C]cyanide based radiotracer development.