This review aims to analyze the technological and scientific applications regarding cocoa fermentation through a prospective study of patent documents and research articles. The Espacenet database was used as a patent research tool by searching both the IPC code “A23G1” and the terms “cocoa” and “ferment*”. A total of 130 documents were found—49 were related to the subject. The Scopus database was also searched for scientific articles using the terms “cocoa” and “fermentation”. A total of 812 articles were found—517 were related to the subject. Cocoa fermentation has not yet reached technological maturity, despite the growth in patent documents and scientific research observed in the last two decades. The creation of the Cacao of Excellence Program (2009), among others, has incentivized sustainability and quality in cocoa-producing countries. Brazil, Colombia, and Indonesia are leading with scientific publications in the last 5 years, despite the lack of patents filed. The United Kingdom, France, China, Canada, and Germany, despite not being cocoa-producing countries, are the main holders of the technology. Patent documents analyzed relate to food science, biotechnology, engineering, and chemistry. Microbial biotechnology has gained attention as a key factor to produce a higher-quality cocoa bean. Saccharomyces is the most frequent genus of yeast used as a starter culture in patent documents. Some patent documents propose the addition of fruits during cocoa fermentation, but a few scientific studies have been found on the matter. Overall, technological applications and scientific studies have focused on improving cocoa quality. The cocoa market is expected to increase significantly in the next few years, representing an opportunity to develop high-quality cocoa using novel fermentation techniques.