Ge vertical heterostructures grown on deeply-patterned Si(001) were first obtained in 2012 (C.V. Falub et al., Science2012, 335, 1330-1334), immediately capturing attention due to the appealing possibility of growing micron-sized Ge crystals largely free of thermal stress and hosting dislocations only in a small fraction of their volume. Since then, considerable progress has been made in terms of extending the technique to several other systems, and of developing further strategies to lower the dislocation density. In this review, we shall mainly focus on the latter aspect, discussing in detail 100% dislocation-free, micron-sized vertical heterostructures obtained by exploiting compositional grading in the epitaxial crystals. Furthermore, we shall also analyze the role played by the shape of the pre-patterned substrate in directly influencing the dislocation distribution.