Catalytic asymmetric cyanation reactions of aldehydes and ketones provide efficient routes for the synthesis of optically active cyanohydrins, which are versatile synthons for the preparation of natural products and chemical pharmaceuticals. This review aims to provide a summary of recent achievements concerning catalytic enantioselective cyanation reactions of aldehydes and ketones employed in the total syntheses of various natural products, drugs, and pharmaceutically active compounds. [ABSTRACT FROM AUTHOR]