Resistant starch (RS) cannot be digested in the small intestine but can be fermented by microflora in the colon. To meet the demand for RS, effective methods and advanced equipment for preparing RS have emerged, but further development is needed. RS contents are affected by different prepared methods, starch source and certain nutrients such as protein, phenols, and hydrocolloids interacted with RS. As a beneficial fermentation substrate, RS modifies and stabilizes the intestinal flora to balance the intestinal environment and improve intestinal tract health and function. RS is also a kind of ingredient with potential physiological function, even better than that dietary fiber, but also in terms of providing various health benefits. RS has good food-processing characteristics as well and can thus be widely used in the food industry.