Menaquinone is essential in electron transport and ATP generation in all Gram-positive, and anaerobically respiring Gram-negative bacteria. By inhibiting menaquinone production in target organisms, bactericidal action can be achieved irrespective of the organisms' growth phase. This pathway is absent in human cells, as menaquinone is obtained only through the diet. This paper provides a succinct review of major advancements, where present, at all enzymatic steps of the biosynthetic pathway of menaquinone. Structure–activity relationships are evaluated, as well as results translating these relationships to growth inhibition studies.