Carp is an important aquaculture species globally, and the production is expected to increase with the growing market demands. Despite that, disease outbreaks remain a major challenge, impeding the development of sustainable carp farming. Moreover, the application of antibiotics, a common prophylactic agent, can adversely impact public health and the environment. Therefore, polysaccharide has been recognized as a novel prophylactic agent in the health management of carp farming, as well as gaining consumers’ confidence in carp farming products. In this review, the definition, sources, and main roles of polysaccharides in improving growth performance, stimulating the immune system, enhancing disease resistance, and alleviating abiotic stresses in carp farming are discussed and summarized. In addition, the use of polysaccharides in combination with other prophylactic agents to improve carp farming production is also highlighted. This review aims to highlight the roles of polysaccharides and provide valuable information on the benefits of polysaccharides in carp farming.