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Inorganic scale deposits are a major water-related problem encountered in producing oil and gas wells. The harshness of scale deposits is dependent on the field operating conditions. Scale deposits can vary from mild scaling tendencies to extreme. In general, the scale deposit will cause a reduction in formation pores, declining productivity and eventually blockage of the wellbore and hence unexpected downtime if it is allowed to persevere. To overcome this, the productivity of an oil and gas well is ensured by handling scale deposits via removal or prevention methods. Scale prevention is the best and cost-effective method for handling scale deposits that ensures production continuity. Inhibition through “threshold” scale inhibitor treatment is the most common method that is proven to prevent or reduce likely deposits. This paper examines the art of synthetic scale inhibitors, in particular, threshold scale inhibitors in oil and gas production. It discusses the chemistry of those inhibitors, inhibition mechanisms, treatment methods and key properties for their applications. It also highlights the chemistry of the synthetic routes often used to produce them in the laboratory and/or industry. Finally, it highlights the environmental concerns for the applicability of threshold scale inhibitors.