High hydrostatic pressure has become an industrial reality, and although there are still many aspects under research, today it is possible to buy high-pressurized products in many countries. Indeed, pasteurization of food products using elevated pressure at room temperature has been accepted by regulatory agencies for commercial use. The quality displayed in such products includes better nutritional retention, fresh-like flavor, improved color, texture, and taste, and extended shelf life compared to thermally pasteurized products. There are several applications of high hydrostatic pressure (HHP) use today in processing fruits, vegetables, meats, seafood, dairy and egg products, including the intelligent combination of pressure, temperature, and time to generate specific characteristics in certain products. One of the biggest challenges in highpressure application is in the sterilization of low-acid foods with combined elevated pressure (600-800 MPa), moderate temperatures (30-90°C), and short processing times (less than 5 min). Combined pressure and temperature, also known as pressure-assisted thermal sterilization (PATS), was recently approved by the FDA in 2009 for commercial sterilization. This manuscript is an update of the stateof-the-art in high-pressure technology, showing the advances achieved in past years and its most recent applications today in food processing. Inactivation of different microorganisms and the potential use of mathematical models to describe and validate the process are also mentioned, including using PATP to achieve sterilization parameters. Facts pertaining to equipment and operation costs are included as well to show that as a new technology, high-pressure use would likely require high initial investment. However, given the productivity and capability of this technology to enhance food quality, it may well deserve this initial investment, as many food companies have indicated in their annual cost reports.