A large proportion of all life on Earth lives in the ocean. Marine life includes microscopic life, plants, algae, invertebrates, fungi, and vertebrates. Due to the high salinity, high pressure, hypoxic and low temperature of the marine environment, the polysaccharides or glycans synthesized by marine life have diverse structures and unique biological activities that are not found in glycans in terrestrial life. Moreover, the glycans are the most abundant biopolymers made by the marine life. The reported activities of marine glycans include but not limit to anticoagulant, antithrombotic, antitumor, antioxidant, antiviral, and antibacterial activities. Published reports on marine glycans have increased more than threefold during the past decade. Meanwhile, several pharmaceutical companies in different countries have invested in the research and development of marine glycan-based drugs. Propylene glycol alginate sodium sulfate (PSS), the first marine glycan-based drug developed in China approved by the Chinese FDA, has been used in the treatment of cardiovascular and other diseases for more than 30 years. In this chapter, the structural characteristics, pharmacological activities and clinical applications of three Chinese FDA approved and commercially available marine glycan-based drugs (PSS, PGMS, and FPS) and five marine glycan-based drugs at different stages of clinical studies (GV971, 911, PGS, PS916, and HS203) in China will be reviewed and discussed. Understanding the marine glycan-based drugs at structure and function level would be needed to comprehend their clinical efficacy. Such knowledge will provide molecular basis for the future research and development of marine glycan-based drugs world widely.