Hippophae rhamnoides is a traditional Chinese medicine with homology of medicine and food, which has the effects of relieving cough and resolving phlegm, strengthening the stomach and digestion, and promoting blood circulation and resolving blood stasis. H. rhamnoides contains not only flavonoids, phenols, proteins, vitamins, and amino acids but also abundant polysaccharides. In order to explore the functional value and current research status of H. rhamnoides polysaccharides, this study systematically summarized the extraction process, structural characteristics, pharmacological effects, and mechanism of action of H. rhamnoides polysaccharides by reviewing Chinese and foreign literature. The results showed that H. rhamnoides polysaccharides have anti-tumor, hypoglycemic, antioxidant, immune regulation, anti-inflammatory, and anti-hyperlipidemia functions and could improve intestinal microbiota. There were various extraction processes for polysaccharides, including hot water extraction, microwave extraction, ultrasonic extraction, enzymatic extraction, flash extraction, ultrasonic-microwave synergistic extraction, emerald hot water extraction, enzymatic-ultrasonic synergistic extraction, etc. Based on comprehensive analysis, hot water extraction is suitable for industrial development and application. However, multiple homogeneous polysaccharides have been isolated and purified from H. rhamnoides polysaccharides, but their efficacy, structure, and structure-activity relationship still need to be further explored and studied. This study can provide a reference for the research and development of H. rhamnoides polysaccharides.