The technology of high-density electropulsing has been applied to increase the performance of metallic materials since the 1990s and has shown significant advantages over traditional heat treatment in many aspects. However, the microstructure changes in electropulsing treatment (EPT) metals and alloys have not been fully explored, and the effects vary significantly on different material. When high-density electrical pulses are applied to metals and alloys, the input of electric energy and thermal energy generally leads to structural rearrangements, such as dynamic recrystallization, dislocation movements and grain refinement. The enhanced mechanical properties of the metals and alloys after high-density electropulsing treatment are reflected by the significant improvement of elongation. As a result, this technology holds great promise in improving the deformation limit and repairing cracks and defects in the plastic processing of metals. This review summarizes the effect of high-density electropulsing treatment on microstructural properties and, thus, the enhancement in mechanical strength, hardness and corrosion performance of metallic materials. It is noteworthy that the change of some properties can be related to the structure state before EPT (quenched, annealed, deformed or others). The mechanisms for the microstructural evolution, grain refinement and formation of oriented microstructures of different metals and alloys are presented. Future research trends of high-density electrical pulse technology for specific metals and alloys are highlighted.