Alkylations of 4-cyano-1,3-dioxanes (cyanohydrin acetonides) represent a hi
ghly practical approach to syn-1,3-diol synthesis. Herein we present a comp
rehensive summary of cyanohydrin acetonide chemistry, with particular empha
sis on practical aspects of couplings, as well as their utility in natural
product synthesis. Both 4-acetoxy-1,3-dioxanes and 4-lithio-1,3-dioxanes ha
ve emerged as interesting anti-1,3-diol synthons. The preparation and utili
ty of these two synthons are described.