Gynostemma pentaphyllum (Thunb.) Makino (GP) (Cucurbitaceae), commonly considered as a folk remedy, has a long history of use in many parts of Asia. Polysaccharides are one of the main components of GP and possess antioxidant, antitumor, anti-inflammatory, immunomodulatory, and cardioprotective properties. In recent decades, Gynostemma pentaphyllum polysaccharides (GPP) have been widely studied for their various health benefits and potential economic value. However, there are relatively few reviews documenting these GPP. Therefore, this paper reviews the research progress of GPP in terms of their sources, isolation and purification, structural characterization, bioactivity, conformational relationships, and applications. It is anticipated that these theoretical foundations will provide a useful reference for the future development and application of natural polysaccharides in functional foods and pharmaceuticals.