Rhodiola, the dried rhizome of various plants of the family Crassulaceae and genus Rhodiola, has been used as a traditional Tibetan medicine for thousands of years, with high medicinal and healthcare value. Polysaccharides, the major active components of Rhodiola, have attracted widespread attention due to their abundant biological activities and medicinal value. Rhodiola polysaccharides (RPs) have various biological activities such as germ cell protection, antioxidant, immunomodulatory, anti-fatigue, hypoglycemic, anti-tumor, and hematopoietic functions. The biological activities of RPs are closely related to their structures and different extraction and purification methods produce different polysaccharide structures. This review aims to provide a comprehensive overview of the research progress in the extraction, purification, structural characterization, bioactivity, potential mechanisms, and structural modification of RPs as well as their potential development prospects and future promising research directions, to lay a foundation for the further development of RP pharmaceutical products.