Tea polysaccharide (TPS) is the second most abundant ingredient in tea following tea polyphenols. As a complex polysaccharide, TPS has a complex chemical structure and a variety of bioactivities, such as anti-oxidation, hypoglycemia, hypolipidemic, immune regulation, and anti-tumor. Additionally, it shows excellent development and application prospects in food, cosmetics, and medical and health care products. However, numerous studies have shown that the bioactivity of TPS is closely related to its sources, processing methods, and extraction methods. Therefore, the authors of this paper reviewed the relevant recent research and conducted a comprehensive and systematic review of the extraction methods, physicochemical properties, and bioactivities of TPS to strengthen the understanding and exploration of the bioactivities of TPS. This review provides a reference for preparing and developing functional TPS products.