In a world increasingly focused on sustainability and integrated resource use, the revalorisation of horticultural by-products is emerging as a key strategy to minimise food loss and waste while maximising value within the food supply chain. Fermentation, one of the earliest and most versatile food processing techniques, utilises microorganisms or enzymes to induce desirable biochemical transformations that enhance the nutritional value, digestibility, safety, and sensory properties of food products. This process has been identified as a promising method for producing novel, high-value food products from discarded or non-aesthetic fruits and vegetables that fail to meet commercial standards due to aesthetic factors such as size or appearance. Besides waste reduction, fermentation enables the production of functional beverages and foods enriched with probiotics, antioxidants, and other bioactive compounds, depending on the specific horticultural matrix and the types of microorganisms employed. This review explores the current bioprocesses used or under investigation, such as alcoholic, lactic, and acetic acid fermentation, for the revalorisation of fruit and vegetable by-products, with particular emphasis on how fermentation can transform these by-products into valuable foods and ingredients for human consumption, contributing to a more sustainable and circular food system.