Recent advances in the study of mycobacterial lipids indicate that the class of outer membrane lipids known as dimycocerosate esters (DIMs) are major virulence factors of clinically relevant mycobacteria including Mycobacterium tuberculosis and Mycobacterium leprae. DIMs are a structurally intriguing class of polyketide synthase-derived wax esters discovered over seventy years ago, yet, little was known until recently about their biosynthesis. Availability of several mycobacterial genomes has accelerated progress toward clarifying steps in the DIM biosynthetic pathway and it is our belief that reviewing the bases of our current knowledge will clarify outstanding issues and help direct future endeavors.