Polygonatum cyrtonema polysaccharides have a variety of pharmacological effects. The commonly used extraction methods include traditional hot water extraction, alkaline extraction, enzymatic hydrolysis method, ultrasonic-assisted extraction, etc., but there are problems such as low yield, high temperature, high cost, strict extraction conditions, and insufficient environmental protection. In this study, crude polysaccharide extraction from the Polygonatum cyrtonema Hua was performed using the freeze–thaw method. Response surface methodology (RSM), based on a three-level, three-variable Box–Behnken design (BBD), was employed to obtain the best possible combination of water-to-raw material ratio (A: 30–50), freezing time (B: 2–10 h), and thawing temperature (C: 40–60 °C) for maximum polysaccharide extraction. Using the multiple regression analysis and analysis of variance (ANOVA), the experimental data were fitted to a second-order polynomial equation and were used to generate the mathematical model of optimization experiments. The optimum extraction conditions were as follows: a water-to-raw material ratio of 36.95:1, a freezing time of 4.8 h, and a thawing temperature of 55.99 °C. Under the optimal extraction conditions, the extraction rate of Polygonatum cyrtonema Hua polysaccharide (PCP) was 65.76 ± 0.32%, which is well in close agreement with the value predicted by the model, 65.92%. In addition, PCP has significant antioxidant activity. This result shows that the freeze–thaw method can improve the extraction efficiency, maintain the structural integrity of polysaccharides, simplify the extraction process, promote the dispersion of polysaccharides, and is suitable for large-scale industrial production.