Extrusion is a crucial food processing technique that involves mixing, heating, shearing, molding, and other operations to modify the structures and properties of food components. As the primary energy source material, the extrusion process induces significant physical and chemical changes in starch that impact the quality of final products. This review paper discusses novel technologies for starch extrusion and their influence on the physical and chemical properties of starch-based foods, such as gelatinization and retrogradation properties, structural characteristics, and digestion properties. Additionally, it examines the application of extrusion in starch processing and the interactions between starch and other food components during extrusion. This information sheds light on the structural and property alterations that occur during the extrusion process to create high-quality starch-based foods.