As one of the most important structural motifs in natural compounds and active pharmaceutical ingredients, azaspiro[4.5]trienones derivatives have been widely used in the field of organic synthesis due to their excellent structural properties and biological activities. In recent years, several methods, such as transition metal involvement, visible light promotion, transition metal-free involvement and electrochemical promotion, have been used to efficiently construct various functional groups of azaspiro[4.5]trienones. The recent advances in the synthesis of azaspiro[4.5]trienones are reviewed...