Spark plasma sintering (SPS), initially developed as an advanced sintering technique for consolidating nanopowders into nanostructured bulk materials, has been recently looked at in much broader perspective and gained a strong reputation of a versatile method of solid state processing of metals, ceramics, and composites. The powders in the SPS-dies experience the action of pulsed electric current and uniaxial pressure; they are heated at very high rates unachievable in furnace heating and sintered within shorter times and at lower temperatures than in conventional methods. The principle of SPS and convenient design of the facilities make it attractive for conducting solid state synthesis. In this paper, based on our own results and the literature data, we analyze the microstructure formation of the products of chemical reactions occurring in the SPS in an attempt to formulate the requirements to the microstructure parameters of reactant mixtures and SPS conditions that should be fulfilled in order to produce a nanostructured material. We present successful syntheses of nanostructured ceramics and metal matrix composite with nanosized reinforcements in terms of microstructure stability and attractive properties of the materials and discuss the challenges of making a dense nanostructured material when reaction and densification do not coincide during the SPS. In the final part of the paper, we provide an outlook on the further uses of reactive SPS in the synthesis of nanostructured materials.