Polygonatum (Huang Jing), encompassing species such as Polygonatum sibiricum, Polygonatum kingianum, and Polygonatum cyrtonema, is known for its edible and medicinal tubers, boasting a history of use spanning thousands of years and significant nutritional and therapeutic value. Polygonatum polysaccharides are among its key bioactive components. Numerous studies have demonstrated that these polysaccharides exhibit various biological activities, such as antioxidant, immunomodulatory, blood sugar regulation, and anti-tumor effects, highlighting their potential applications in functional foods and medicine. This paper summarized the differences in structure and activity of Polygonatum polysaccharides and discussed the impacts of different extraction and purification methods on their structure and bioactivity. It aimed to provide a theoretical basis for the optimal utilization of Polygonatum polysaccharides and further research on the relationship of polysaccharides structure and its activities from different Polygonatum species.