Synthetic methodologies for gangliosides have evolved over the past three decades. The strategies for constructing ganglioside skeletons can generally be classified as late-stage ceramide coupling, the glucosyl ceramide cassette strategy, or late-stage sialylation. Using these synthetic strategies, numerous natural gangliosides and their structural analogs, including functional probes, have been synthesized. This chapter describes the synthetic strategies for gangliosides and provides examples of the total synthesis of several gangliosides using each strategy.