The classical repertoire of synthetic organic chemistry is short of methods that allow triple bonds to be transformed into (E)-alkenes with high selectivity in the presence of other reducible sites. Recent advances, most notably in ruthenium-catalyzed trans-hydrogenation, trans-hydrosilylation, trans-hydrogermylation, trans-hydrostannation, and even trans-hydroboration hold the promise of filling this gap. This review illustrates the state-of-the-art in the field by summarizing applications of these emerging methodologies to natural product synthesis. A comparison of ruthenium-catalyzed and radical-induced trans-hydrostannations provides further insights into the application profile of these transformations