Tetrahydro-γ-carbolines (THγCs) constitute one of the most important subtypes of indole alkaloids. In addition to being substructures of natural products, these structural motifs and moieties can often be found in pharmaceuticals due to their diverse bioactivities such as antiviral, antibacterial, antifungal, antiparasitic, antitumor, anti-inflammatory, and neuropharmacological activities. Beyond the pharmacological and biological aspects of these scaffolds, they have considerable synthetic applications for the construction of further bioactive compounds, too. The aim of this review is to summarize recent developments in the synthesis of this compound class.