Scientists from across the world are being inspired by recent development in polysaccharides and their use in medical administration. Due to their extraordinary physical, chemical, and biological characteristics, polysaccharides are excellent materials for use in medicine. Acidic polysaccharides, which include Pectin, Xanthan gum, Carrageenan, Alginate, and Glycosaminoglycan, are natural polymers with carboxyl groups that are being researched for their potential as drug delivery systems. Most publications do not discuss how the different polysaccharides interact structurally in terms of drug delivery, which limits the scope of their use. The purpose of this review is to inform readers about the structural activity correlations between acidic polysaccharides, their different modification process and effects of combination of various acidic polysaccharides which have been used in drug delivery systems and expanding their potential applications, and bringing new perspectives to the fore.