<p>Worldwide, fermented foods and beverages with plant and animal origins are significant sources of nutrients. These food types supply vital nutrients, including free radical oxygen, vitamins, cofactors, and other compounds that support human health and provide immunity against physiological circumstances and infectious diseases. Exopolysaccharides (EPS) that some lactic acid bacteria (LAB) can generate have beneficial biological and technological properties. The LAB-EPS contribute to the technological benefits of foods, such as improved viscosity, creaminess, texture, water-holding capacity, and moisture retention. A wide range of food types, including dairy products, baked goods, fermented plant-based drinks, and meat products, have successfully used LAB-EPS. Besides these useful biological features, some LAB-EPS also have bioactivities like antimicrobial, gut-modulating, and antioxidant benefits, which shows that they are both structural and bioactive ingredients. But the low cost of production and high cost of purchase make it challenging for them to grow. A lot of research has been done on LAB-derived EPS to see how they can improve output, but there aren’t many reports that explain and summarise the relationships between the biosynthesis pathway, strain selection, production parameters, and the structure–function relationship. Thus, this review addresses the biosynthesis mechanism, the structure–function relationship of LAB-derived EPS, applications, health-promoting facts, and future gaps.</p>