Background: Poria cocos (Schw.) Wolf possesses therapeutic potential of diuretic, phlegm, and uneasiness of mind in ethnomedicine. Polysaccharides, one kind of the major active ingredients of P. cocos, are considered to be responsible for their versatile use. Now, a systematic summary of research progress and future prospects of polysaccharides from P. cocos (PCPs) are necessary to facilitate their further study and application. Scope and Approach: In this review, we emphasize the optimal extraction and purification methods, structural features, and biological activities of PCPs. The structure-activity relationships (SAR) is also analyzed and summarized. Key Findings and Conclusions: Ultrasonic, microwave, enzyme assisted and supercritical carbon dioxide methods have been used to extract PCPs. Among them, ultrasonic technique is the most efficient. PCPs exhibited various bioactivities, including immunomodulation, anti-inflammation, anti-angiogenesis and anticancer. SAR reveal that water solubility, molecular weight, and chain conformation of PCPs are closely related to its biological activity. However, new method for purification of certain polysaccharides, detailed SAR, mechanisms of bioactivities, and quality control of PCPs need to be extensively investigated. (C) 2016 Elsevier Ltd. All rights reserved.