Because hydroxypropyl starch (HPS) represents an important chemical modification of starch, extensive studies on hydroxypropylation are being carried out at various research centers worldwide. The present review summarizes development of methods for determination of the MS (molar substitution)/DS (degree of substitution) of hydroxypropyl starch, location of hydroxypropylation reaction sites in granules and on amylose and amylopectin molecules, and factors affecting reaction efficiency. Also presented is an overview of changes of physicochemical properties of starch that result from hydroxypropylation. Specifically reviewed are the effects of hydroxypropylation on granule morphology, crystallinity, thermal properties, swelling, and solubility; pasting, paste, and retrogradation properties; rheological and textural properties of HPS gels; and digestibility and uses of HPS.