The use of polysaccharides as building blocks in the development of nano-sized drug delivery systems is rapidly growing. This can be attributed to the outstanding virtues of polysaccharides such as biocompatibility, biodegradability, low toxicity and low cost. In addition, the variety of physicochemical properties and the ease of chemical modifications enable the preparation of a wide array of nanoparticles. This tutorial review describes the properties of common polysaccharides, the main mechanisms for polysaccharide based-nanoparticles preparation, and provides examples from the conceptual design towards pre-clinical and clinical applications.