Consumption milk with longer shelf-life is nowadays required to have access to markets of distant countries. Novel technologies for milk processing, alternative to conventional heat-treatments, may provide milk industry with reliable, efficient and clean equipment for consumption milk manufacture. This review addresses the most promising technologies, either under experimental examination or already commercially available. In particular, scientific literature documenting the performances of ohmic heating, microwaves, radio frequency, microfiltration, high pressure, and pulsed electric field is presented. Attention is given to the respective effectiveness in destroying microorganisms, inactivate enzymes, avoid damage to milk components as well as to the consequent microbiological and physicochemical stability of processed milk during storage. Although most technologies allow destroying or remove vegetative bacterial cells, so far none proves to represent a comprehensive alternative to conventional heat treatments of milk. Microfiltration is currently applied as a preliminary treatment in production of extended shelf life (ESL) pasteurized milk, however successful applications in UHT milk manufacture have been proposed as well. High-pressure homogenization prolongs physical stability to conventionally heat-treated milk. The combination of an alternative technology, most promisingly pulsed electric field, with mild thermal treatments represents, at the moment, the sole realistic approach to produce fresh-like/high quality pasteurized milk.