Abstract: Highland barley is the main food of Tibetan people, which is rich in starch, fat, protein, vitamins, dietary fiber, β-glucan, polyphenol, amino acid, etc. Highland barley has widely healthy functions such as hypolipidemic, hypoglycemic, cholesterol lowing, antioxidation, and gastrointestinal regulation, etc. Due to the special characteristics including bran thickness, taste bad, and indigestible of the crude material, as a result that highland barley could be edible after processing. Superheated steam, baking, frying, steaming, boiling, and other hot processing methods as well as germination are common processing methods for highland barley. Different processing steps of highland barley would have a certain impact on the contents and structures of its nutritional compositions, and the biological activities such as hypolipidemic and hypoglycemic are also varied. Therefore, this paper reviews the effects of different processing methods on nutrients and bioactivities of highland barley in recent 10 years, and its variable regular and influencing factors are also discussed. Finally, the development of functional food products of highland barley is prospected. It has certain reference value for the in-depth digging, quality improvement, technological innovation and new product development of highland barley.