The genus Polygonatum is gaining increasing attention from nutrition experts as well as health-conscious consumers because of its excellent performance in providing nutrients. Among these plants, Polygonatum sibiricum and Polygonatum odoratum have been selected for inclusion in China's Medicinal Food Directory due to their high safety profile. Polysaccharides are considered the main functional component and one of the main active ingredients of the plant. In addition, polysaccharides from genus Polygonatum have a variety of nutritional, biological and health-promoting properties, such as immunomodulatory, anti-inflammatory, cardiovascular protective, neuroprotective, antitumor, antidiabetic, antiosteoporosis, and hepatoprotective properties. This paper reviews the origin, extraction, purification, structural characteristics, biological activity, safety, toxicological evaluation, and structure-activity relationship of polysaccharides from the genus Polygonatum. Ultimately, we hope that this work can provide a more useful reference for understanding the polysaccharide structure and developing of new functional foods from polysaccharides of the genus Polygonatum.