Pellets exhibit major therapeutic and technical advantages which have established them as an exceptionally useful dosage form. A plethora of processes and materials is available for the production of pellets, which practically allows inexhaustible configurations contributing to the flexibility and versatility of pellets as drug delivery systems. The scope of this review is to summarize the recent literature on pelletization processes for pharmaceutical applications, focusing on the awarded and pending patents in this technical field. The first part of the article provides an overview of innovation in pelletization processes, while the second part evaluates their novel applications.