High pressure processing (HPP) allows the decontamination of foods with minimal impact on their nutritional and sensory features. The use of HPP to reduce microbial loads has shown great potential in the meat, poultry and seafood industry. HPP has proven to be a promising technology, and industrial HPP applications have grown rapidly, especially in the stabilization of readyto-eat meats and cured products, satisfying the demands of regulatory agencies such as the United States Department of Agriculture-Food Safety and Inspection Services (USDA-FSIS). HPP has been investigated for a wide range of operations including non-thermal decontamination of acid foods, combined pressure-heating treatments to inactivate pathogenic bacteria, pressure-supported freezing and -thawing, texturization and the removal of meat from shellfish and crustaceans. Research has also been conducted on the impact of the technology on quality features. Processing-dependent changes in muscle foods include changes in colour, texture and water-holding capacity, with endogenous enzymes playing a major role in the phenomena. This review summarizes the current approaches to the use of high hydrostatic pressure processing, focusing mainly on meat, meat products and seafood. Recent findings on the microbiological, chemical and molecular aspects of HPP technology, along with commercial and research applications, are also described.