This review describes the different plant transformation techniques, including guided infection with Agrobacterium tumefaciens and A. rhizogenes, particle bombardment and protoplast fusion, that have been attempted to create transgenic Catharanthus roseus (L.) G. Don cell cultures, hairy roots and whole plants. The review also focuses on the different approaches used to manipulate and improve secondary metabolite yields in various culture systems, with special attention to the most relevant results achieved. Finally, under future perspectives, the authors propose several approaches which would likely be implemented with this species, to try to boost the accumulation of the anti-tumour agents, vinblastine and vincristine. Some comments on how the future of the genetic manipulation of medicinal plants may proceed aiming at achieving higher secondary metabolite yields are also given.