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Since the 1990s, concerted attempts have been made to improve the efficiency of medicinal chemistry synthesis tasks using automation. Although impacts have been seen in some tasks, such as small array synthesis and reaction optimization, many synthesis tasks in medicinal chemistry are still manual. As it has been shown that synthesis technology has a large effect on the properties of the compounds being tested, this review looks at recent research in automation relevant to synthesis in medicinal chemistry. A common theme has been the integration of tasks, as well as the use of increased computing power to access complex automation platforms remotely and to improve synthesis planning software. However, there has been more limited progress in modular tools for the medicinal chemist with a focus on autonomy rather than automation.