The starch-lipid complexes have recently attracted extensive interest due to their excellent properties, such as the decrease of digestibility and the inhibition of starch gelatinization and retrogradation. The review discussed the formation, structure, functionalities and preparation methods of starch-lipid complexes, and most importantly, their application. The starch-lipid complex is classified as a new type of resistant starch-RS5, which can reduce postprandial blood glucose response and regulate human gut health. Over the past few years, starch-lipid complexes have been increasingly reported for applications in food additives, fat substitutes and carriers of nutrients and medicine, regulation of intestinal flora and production of food packaging films. A comprehensive review of applications of starch-lipid complexes is of great importance for understanding and expanding the application of complexes. But the regulatory mechanism of starch-lipid complexes on food quality, food packaging films and intestinal flora is still unclear, which deserves further study in the future. Targeted medicine delivery using starch-lipid complexes may be also a promising and challenging direction in the future.