Climate change is a global concern that has the potential to negatively impact crop yields. In this challenging scenario of fulfilling the hunger of a growing population, millets have an outstanding ability to overcome harsh climatic conditions. Millets are a significant starch source with several health-promoting benefits, as they are rich in resistant starch (RS) and have a lower glycemic index. However, the native starches are functionally restricted for food applications because of their instability to withstand processing conditions. Hence, modification of starch is necessary to engender their functionality. Ultrasonication is one of the most promising technologies employed for starch modification. This review provides insight into the mechanism of ultrasound responsible for the isolation and modification of millet starch. This article also summarizes the effect of ultrasonic treatment on the chemical, functional, pasting, rheological, thermal, in-vitro, and structural properties of millet starch and the severity of modification depending upon ultrasonic factors such as power-induced, treatment time, surrounding temperature, and applied frequency. Overall, ultrasound technology has great potential to be used in food industries for improved functionalities of millet starches.