Compared with traditional thermal process pasteurization, high hydrostatic pressure sterilization technology can achieve good sterilization effect and ensure the original flavor and nutritional value in food as well. Therefore, in order to guarantee the reliability and safety of high hydrostatic pressure sterilization technology, it is necessary to study the factors that affect the sterilization performance thoroughly. Previous studies have focused on the pressure holding stage to obtain optimal conditions for sterilization, including pressure level, pressure holding time and temperature etc. However, a series of studies have shown that pressurization and depressurization will also affect the sterilization performance. In this paper, the main factors affecting the sterilization performance of high hydrostatic pressure were introduced briefly, and the effects of pressurization and depressurization on sterilization were introduced with special efforts. This review aims to promote the application of high hydrostatic pressure sterilization technology in food processing industry in China.