In this paper we review the recent developments in the synthesis of α-substituted hydroperoxides. α-Substituted hydroperoxides are interesting compounds due to their chemistry and bioactivity and as intermediates for the synthesis of other peroxides, of which cyclic peroxides are of major importance. Although the emphasis of this report will be on the derivatives of gem-dihydroperoxides, perketals, as well as the less studied nitrogen and sulfur derivatives, will also be covered.