Native starches have limited applications in the food industry due to their unreactive and insoluble nature. Cold plasma technology, including plasma-activated water (PAW), has been explored to modify starches to enhance their functional, thermal, molecular, morphological, and physicochemical properties. Atmospheric cold plasma and low-pressure plasma systems have been used to alter starches and have proven successful. This review provides an in-depth analysis of the different cold plasma setups employed for starch modifications. The effect of cold plasma technology application on starch characteristics is summarized. We also discussed the potential of plasma-activated water as a novel alternative for starch modification. This review provides information needed for the industrial scale-up of cold plasma technologies as an eco-friendly method of starch modification.