Demand for ultra‐high‐temperature (UHT) milk and milk protein‐based beverages is growing. UHT milk is microbiologically stable. However, on storage, a number of chemical and physical changes occur and these can reduce the quality of the milk. These changes can be sufficiently undesirable so as to limit acceptance or shelf life of the milk. The most severe changes in UHT milk during storage are age gelation, with an irreversible three‐dimensional protein network forming throughout, excessive sedimentation with a compact layer of protein‐enriched material forming rapidly at the bottom of the pack, and creaming with excessive fat accumulating at the top. For age gelation, it is known that at least two mechanisms can lead to gelation during storage. One mechanism involves proteolytic degradation of the proteins through heat‐stable indigenous or exogenous enzymes, destabilizing milk and ultimately forming a gel. The other mechanism is referred to as a physico‐chemical mechanism. Several factors are known to affect the physico‐chemical age gelation, such as milk/protein concentration, heat load during processing (direct compared with indirect UHT processes), and milk composition. Similar factors to age gelation are known to affect sedimentation. There are relatively few studies on the creaming of UHT milk during storage, suggesting that this defect is less common or less detrimental compared with gelation and sedimentation. This review focuses on the current state of knowledge of age gelation, sedimentation, and creaming of UHT milks during storage, providing a critical evaluation of the available literature and, based on this, mechanisms for age gelation and sedimentation are proposed.