As one of the main fragments in medical drugs, spirooxindole has received considerable attention from organic and medicinal chemists. In the past few decades, chemists have been searching for more straightforward and efficient methods to produce compounds containing a spirooxindole fragment. In this regard, isatin-derived Morita-Baylis-Hillman (MBH) carbonates have been widely used as versatile building blocks for the synthesis of spirooxindole structures. This review summarizes the reactions reported in recent years for the construction of the spirooxindole skeleton or C3 disubstituted oxindole derivatives using isatin-derived MBH carbonates and demonstrates the role of isatin-derived MBH carbonates in these reactions.