Abstract: Tremella fuciformis is rich in nutrients, and Tremella fuciformis polysaccharide is the most important functional active component with a variety of biological activities. Tremella fuciformis polysaccharides can be prepared by various methods, and the research on its structure is mainly focused on molecular weight, monosaccharide components, and glycosidic bond type. This review summarizes the preparation, structure, and biological activities of Tremella fuciformis polysaccharides, such as antioxidant, anti-tumor, immune regulation, memory improvement, anti-inflammation, blood sugar and blood lipid lowering, and its development and application in food, cosmetics, and medicine. In the future, it is necessary to optimize the preparation technology of Tremella fuciformis polysaccharides, analyze the advanced structure of Tremella fuciformis polysaccharides with modern analytical techniques, and conduct in-depth research on the function and mechanism of action of Tremella fuciformis polysaccharides, so as to provide theoretical reference for the deep processing and product development of Tremella fuciformis fuciformis.