The study of higher-dimensional black holes is a subject which has recently attracted vast interest. Perhaps one of the most surprising discoveries is a realization that the properties of higher-dimensional black holes with the spherical horizon topology and described by the Kerr-NUT-(A)dS metrics are very similar to the properties of the well known four-dimensional Kerr metric. This remarkable result stems from the existence of a single object called the principal tensor. In our review we discuss explicit and hidden symmetries of higher-dimensional Kerr-NUT-(A)dS black hole spacetimes. We start with discussion of the Killing and Killing-Yano objects representing explicit and hidden symmetries. We demonstrate that the principal tensor can be used as a "seed object" which generates all these symmetries. It determines the form of the geometry, as well as guarantees its remarkable properties, such as special algebraic type of the spacetime, complete integrability of geodesic motion, and separability of the Hamilton-Jacobi, Klein-Gordon, and Dirac equations. The review also contains a discussion of different applications of the developed formalism and its possible generalizations.