Tetrazole-fragmentation under mild condition from 5-hydroxyalkyl-1H-tetrazoles (HATs) or cyanophosphates readily generates the corresponding alkylidene carbenes, which undergo [1,2]-rearrangements or [1,5]-C−H insertions to yield one-carbon homologous alkynes or five-membered unsaturated carbocycles, respectively. Furthermore, azido-HATs and 2-cyanoazetidines afford propargylic and homopropargylic amines, respectively, via the [1,2]-rearrangements of the corresponding aminoalkyl alkylidene carbenes. These reactions have been successfully applied for the synthesis of various biofunctional molecules. This review summarizes the progress made in this methodology over the last decade.