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The review attempts to deal with the state of the art of UHT milk processing, economics, packaging, and quality maintenance. Various methods of processing are covered in detail. A sample system was considered for material and energy balances. A major factor in UHT milk technology is the economics of the process adopted. This is considered for the major processes currently in operation. Packaging and handling of UHT milk is of vital importance for the maintenance of the quality and flavor of the milk. A review of the different packaging systems describes the advantages and disadvantages of each one. The review is divided into the following sections: (1) major direct and indirect processes, (2) energy requirements and economics, (3) material and energy balances for fluid milk processing, storage, and distribution systems, (4) aseptic packaging, and (5) quality effects.