DNA and RNA are the molecules which store the genetic information in every organism. Both macromolecules are severely damaged by a variety of exogenous and endogenous events. This leads to a loss of genetic information. Main lesions are strand breaks, apurinic and apyrimidinic sites and a variety of DNA bases with an altered structure. The result of these DNA modifications are cell death, mutations and in the worst scenario carcinogenous growth. In order to study the effect of DNA lesions on the structure of the DNA double helix, a variety of lesion building blocks were recently synthesized and incorporated into oligonucleotides. In addition, oligonucleotides which contain DNA lesions at specific sites are the basis for a detailed investigation of repair mechanisms that were developed by organisms in order to counteract the lethal effect of DNA damage. This review article describes the recent synthetic progress that has enabled the preparation of DNA lesion phosphoramidite building blocks. The synthetic procedures employed for their preparation and the methods used to incorporate these building blocks into oligonucleotides are described. The biological effect of each particular lesion is briefly recapitulated.