Natural polysaccharides such as starch, cyclodextrin and so on are widely used as excipients in pharmacy. These biodegradable, biocompatible, and hydrophilic polysaccharides contain different functional groups (such as hydroxyl, carboxylic acid, amino) that make them ideal for conjugation. In recent years, the utilization of polysaccharides and their derivatives in drug delivery is in the ascendant, these polysaccharides based polymer-drug conjugates are applied to the fields of targeted drug delivery, tissue engineering and bioadhesive technology, and other biomedical applications. This paper presented an overview of the research status of polysaccharide-drug conjugates, including the design and formulation of conjugates, and their applications in drug delivery system. In addition, the functional roles of polysaccharide in conjugate system and the future direction in the developments of polysaccharide-drug conjugates were also been mentioned.