Punica granatum L., commonly known as pomegranate, is native to Afghanistan and Iran, and today widely cultivated all over the world. Pomegranate polysaccharides are one of the most important bioactive components of P. granatum, which have a wide range of beneficial biological activities, such as anticancer, immunostimulatory, hepatoprotection, anti-psoriasis and antioxidation. Hot water extraction is currently the most commonly used method to isolate pomegranate polysaccharides. The structural characteristics of pomegranate polysaccharides have been extensively investigated through various advanced modern analytical techniques. This review focuses on the extraction, purification, structural characteristics, biological activities and structure-activity relationships of polysaccharides from Punica granatum. The aim of this article is to comprehensively and systematically summarize recent information of polysaccharides from Punica granatum and to serve as a basis for further research and development as therapeutic agents and functional foods.