Metal halide perovskite semiconductor nano-crystals have emerged as a lucrative class of materials for many optoelectronic applications. By leveraging the synthetic toolboxes developed from decades of research into more traditional semiconductor nanocrystals, remarkable progress has been made across these materials in terms of their structural, compositional, and optoelectronic control. Here, we review this progress in terms of their underlying formation stages, synthetic approaches, and postsynthetic treatment steps. This assessment highlights the rapidly maturing nature of the perovskite nanocrystal field, particularly with regard to their lead-based derivatives. It further demonstrates that significant challenges remain around precisely controlling their nucleation and growth processes. In going forward, a deeper understanding of the role of precursors and ligands will significantly bolster the versatility in the size, shape, composition, and functional properties of these exciting materials.