Although the increasing studies have corroborated the biological activities and great market utilization value of polysaccharide fractions derived from Polygonati rhizome, a well-known edible and medicinal plant, Polygonati rhizome polysaccharides (PRPs) still lack sufficient attention. Herein, we make attempt to systematically summarize recent advances in the extraction, purification, structural characteristics, biological activities, and commercial products of PRPs. Based on the detailed extraction and structural characteristics, the biological activities of PRPs including immune-regulation, anti-osteoporosis, anti-Alzheimer's disease, anti-diabetes and anti-atherosclerotic, are emphatically summarized, as well as the possible related mechanisms. Most importantly, about 365 kinds of commercial functional foods and over 500 patents related to PRPs as the main raw material were analyzed to explore the status quo and bottleneck for the development and utilization of PRPs. In conclusion, this review will benefit to bridge the gap between basic knowledge and market innovations, and facilitate the in-depth utilization of PRPs.