As the success of nanostructures grows in modern society so does the importance of our ability to control their synthesis in precise manners, often with atomic precision as this can directly affect the final properties of the nanostructures. Hence it is crucial to have both deep insight, ideally with real-time temporal resolution, and precise control during the fabrication of nanomaterials. Transmission electron microscopy offers these attributes potentially providing atomic resolution with near real time temporal resolution. In addition, one can fabricate nanostructures in situ in a TEM. This can be achieved with the use of environmental electron microscopes and/or specialized specimen holders. A rather simpler and rapidly growing approach is to take advantage of the imaging electron beam as a tool for in situ reactions. This is possible because there is a wealth of electron specimen interactions, which, when implemented under controlled conditions, enable different approaches to fabricate nanostructures. Moreover, when using the electron beam to drive reactions no specialized specimen holders or peripheral equipment is required. This review is dedicated to explore the body of work available on electron-beam induced synthesis techniques with in situ capabilities. Particular emphasis is placed on the electron beam-induced synthesis of nanostructures conducted inside a TEM, viz. the e-beam is the sole (or primary) agent triggering and driving the synthesis process.