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Traditional organic synthesis represents more than 150 years of old chemistry, which heavily relies on using toxic, flammable, and hazardous organic solvents. Water has always, or at least until recently, been considered a rival of organic chemists because it is a general practice to perform organic reactions in extremely anhydrous/dry conditions. Indeed, introductory college undergraduate courses term water as a poor solvent to perform organic reactions. This is partly true due to the insolubility or sensitivity of organic reagents towards water. Nevertheless, there are several reactions that can be performed in water. This chapter will also discuss the introduction of additives or surfactants, which are generally added to water for enabling organic synthesis, and organic reactions which are performed in aqueous organic solvents (AOS). Finally, a few case studies of pharmaceutical process chemistry performed in water will be discussed.

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