Background: Cynomorium songaricum Rupr. (CSR), also known as the "Elixir of Immortality", is a perennial fleshy parasitic herb of the family Cynomoriaceae, widely distributed in arid and semi-arid regions globally. It holds dual medicinal and edible value, as well as ornamental potential. Its core active component is Cynomorium songaricum polysaccharide (CSP), which has been shown to possess significant biological activities, including immunomodulation, hypoglycemic effects, antioxidation, and anti-osteoporosis properties. Scope and approach: Based on the PRISMA guidelines, this paper systematically retrieves and summarizes relevant literature from databases such as PubMed, Web of Science, and CNKI. It reviews the latest research progress on the extraction, purification, structural characterization, and biological activities of CSP, and further discusses its structure-activity relationship, potential research directions, and application prospects. Key findings and conclusions: The main extraction methods for CSP include water extraction and enzyme-assisted extraction, while deproteinization and decolorization are commonly achieved using the Sevag method and macroporous resins. Existing studies mainly focus on primary structural features such as monosaccharide composition, molecular weight, and their modifications, with relatively limited exploration of higher-order structures and structure-activity relationships. Overall, research on CSP extraction, purification, primary structure analysis, and pharmacological activity evaluation has become relatively mature. Future studies should focus on fine structural elucidation and structure-activity relationships, while optimizing green and efficient extraction processes, to promote its clinical translation and interdisciplinary applications in modern medicine and the health industry.