Despite being discovered over a century ago, lathyrane diterpenoids have only recently attracted significant attention from the organic chemistry community due to their distinctive carbon framework, characterized by a 5/11/3 tricyclic system. The conformational rigidity of these scaffolds promotes close spatial proximity between functional groups, making transannular reactions a powerful tool for the construction of new complex polycyclic architectures. In parallel, compounds from the genus Euphorbia have emerged as privileged scaffolds in medicinal chemistry, exhibiting a wide range of biological activities, including cytotoxic, antiviral, and neuroprotective effects. This review summarizes recent advances in the field, with particular emphasis on synthetic strategies, structural diversity, and medicinal chemistry aspects of this intriguing class of secondary metabolites.