Fresh fruits and vegetables are integral components of a balanced diet, providing essential nutrients and contributing to human health. However, the postharvest quality of these perishable commodities is greatly influenced by various physiological processes that occur after harvest. This article reviews the key physiological processes affecting postharvest quality, including respiration, transpiration, ripening, senescence, and enzymatic activity. Understanding these processes is crucial for optimizing postharvest handling practices to extend shelf life, maintain quality attributes such as texture, flavor, color, and nutritional content, and minimize losses. Strategies to manage these physiological processes, including temperature and humidity control, modified atmosphere packaging, and the use of postharvest treatments, are discussed. Additionally, emerging technologies and innovative approaches for enhancing postharvest quality and extending the storage life of fresh fruits and vegetables are highlighted. By elucidating the complex interplay of physiological factors influencing postharvest quality, this review aims to provide valuable insights for researchers, practitioners, and stakeholders involved in the fresh produce supply chain, ultimately contributing to the promotion of food security and sustainability.