High pressure processing (HPP) at high temperatures has been investigated to inactivate bacterial spores. By improving HPP using cyclic/oscillatory/pulsed pressure applications or combination with other treatments (such as thermal), and agents (such as antibacterial), bacterial spores can be inactivated, resulting in shelf-stable foods with natural sensory, quality, and nutritional attributes. This paper reviews literature on the recent advances in inactivation of bacterial spores by HPP, including its combination with high temperature, and oscillatory processing. The mechanisms of HPP-induced bacterial spore germination and inactivation are also discussed.