The food industry, one of the most conservative sectors in the production spectrum, is experiencing, as never before, the need for innovation. These days, consumers are much more demanding and better educated in terms of food quality and nutrition, and regulatory agencies are searching for innovative technologies that offer better products with greater safety. At the same time, scientists and avid researchers are incorporating acquired knowledge in a variety of disciplines to blend them with current food science/food engineering domains. This chapter briefly covers principles and applications, as well as recent innovative approaches to preserving foods by high pressure processing (HPP), a nonthermal food preservation technology used in a variety of food products to maintain fresh like quality with extended shelf life under refrigerated conditions where the pressures applied range from 300 to 800 MPa. Application of this technology in foods for decontamination and pasteurization purposes are explained based on microbial safety, organoleptic properties and nutritional values. The potential of HPP to extend the shelf life of fruits and vegetables, meat, seafood, dairy, and other food products is described, as well as suitable packaging materials for this technology. The impact of HPP on sensory properties of foods and consumer attitudes to high pressure processed foods are also reviewed. Emerging challenges while implementing this technology at the industrial level are promoting the integration of what is known and what is coming in the future.