Poria cocos is a both medicinal and edible Chinese herb variety, with the effects of diuretic, spleen-enhancing and tranquilizing. P. cocos polysaccharide(PCP) is one of the most important active substances of P. cocos. Pharmacological research shows that PCP has a variety of pharmacological activities such as regulating immunity, anti-inflammatory, anti-oxidation, antitumor, and liver protection, with a huge development and utilization value. By consulting the relevant literature, we systematically summarized the chemical structures and the research progress on pharmacological activities of PCP and its derivatives in recent years to explore the chemical compositions and activities of PCP thoroughly. In addition, the current problems were discussed in this article to provide reference for further exploration of the structure-activity relationship of PCP and its further development and utilization.