Covering: 1992 to 2024Type-I polyketide synthase (PKS)-derived metabolites are structurally diverse bioactive natural products containing multiple stereogenic centres. This review focuses on the configurational analysis of type-I PKS-derived natural products, emphasizing the methodologies and challenges associated with determining their stereochemistry due to their complex structures with multiple chiral centres. Key strategies include <i>J</i>-based configuration analysis (JBCA), chemical derivatizations with chiral reagents, degradation methods, NMR spectroscopic analysis, and the exploitation of chiroptical properties. Case studies demonstrate the practical applications of these methods in elucidating the stereochemistry of type-I polyketide natural products.