Hydrogels are three-dimensional, hydrophilic, polymeric networks, with chemical or physical cross-links, capable of imbibing large amounts of water or biological fluids. Among the numerous macromolecules that can be used for hydrogel formation, polysaccharides are extremely advantageous compared to synthetic polymers being widely present in living organisms and often being produced by recombinant DNA techniques. Coming from renewable sources, polysaccharides also have frequently economical advantages over synthetic polymers. Polysaccharides are usually non-toxic, biocompatible and show a number of peculiar physico-chemical properties that make them suitable for different applications in drug delivery systems. We review here a selection of the most important polysaccharides that have been studied and exploited in several fields related to pharmaceutics. Particular attention has been focused on the techniques used for the hydrogel network preparation, on the drug delivery results, on clinical applications as well as on the possible use of such systems as scaffolds for tissue engineering.