Due to the unique chemical structures and antitumor activity, tetrahydroisoquinoline alkaloids have long been the focus of widespread concern of chemists and biologists. In particular, with the continuous progress of new biotechnology, the biosynthetic studies of this type of antibiotics have made rapid development over the past decade. In this paper, the main achievements of these studies are reviewed, including the biosynthesis of safracin B, saframycin A, naphthyridinomycin, quinocarcin, and ecteinascidin 743, especially the biosynthetic studies of their core tetrahydroisoquinoline ring structure, such as the core structure precursor resources, the biosynthetic pathway of these precursors, and the formation mechanism of the tetrahydroisoquinoline ring.