Benzocyclobutenones are an intriguing class of four-membered-ring ketones that have been used extensively as powerful synthetic intermediates in organic synthesis. Their high reactivity is primarily attributed to the unique high electrophilicity of the carbonyl unit and the ability to generate o-quinone dimethides, allowing a myriad of different transformations. However, the synthesis of benzocyclobutenones still represents a great challenge. This review provides an overview of the preparation, use and impact of benzocyclobutenones in organic synthesis. Selected applications in the synthesis of natural products are also described, in order to illustrate the utility of these compounds.