The review is devoted to the fundamental aspects of the reactive processing of thermoplastic polymers. First of all, some reactive processing examples, including polymer grafting (vinyl silane, maleic anhydride) and/or functionalization, bulk polymerization (urethane, lactams, acrylate, ∊-capolactone), polyester modification and new copolymers synthesis, are presented. From a fundamental point of view, the review covers the state of the art in the domains of rheology (specifically modelling of rheo-kinetics), diffusion and mixing in highly viscous reactive or non reactive media. Finally, 1, 2 and 3-D simulation of the reactive extrusion process in twin-screw extruder is reported at the end of the review.