Polysaccharides are natural polymer compounds widely distributed in plants, animals, and microorganisms, most of which have a broad spectrum of biological activities to promote human health. They could also be used as texture modifiers in food industry due to their excellent rheological and mechanical properties. Many researchers have shown that nonthermal processing technologies have numerous advantages, such as high extraction efficiency, short extraction time, and environmental friendliness, in the extraction of polysaccharides compared with the traditional extraction methods. Moreover, nonthermal technologies could effectively change the physicochemical properties and structural characteristics of polysaccharides to improve their biological activities or processing properties. Therefore, a comprehensive summary about the extraction and modification of polysaccharides by nonthermal technologies, including ultrasound, high hydrostatic pressure, pulsed electric fields, and cold plasma, was provided in this review. In particular, the underlying mechanisms, processing operations, and current application status of these technologies were discussed. In addition, the applications of combining nonthermal techniques with other technological methods in polysaccharide extraction and modification were briefly introduced.