The total synthesis of a potent multi-drug-resistant reverser, dysoxylacatam A (1), was achieved in a highly efficient and stereocontrolled fashion. The highlights of the strategy enlisted an iterative combination of lithiation-borylation tactics including Aggarwal homologation and Matteson homologation, Brown crotylation, Krische allylation, and ring-closing metathesis to forge the macrocycle.