The expansion and advancement of the meat product market have increased the demand for fermented sausages. A typical method for manufacturing high-quality fermented sausages is using a starter culture, which improves the taste, aroma, and texture. Currently, the starter culture for manufacturing fermented sausages is mainly composed of microorganisms such as lactic acid bacteria, yeast, and fungi, which generate volatile compounds by the oxidation of fatty acids. In addition, protein decomposition and changes in pH occur during the fermentation period. It can positively change the texture of the fermented sausage. In this review, we discuss the requirements (improving food safety, the safety of starter culture, enzyme activity, and color) of microorganisms used in starter cultures and the generation of flavor compounds (heptanal, octanal, nonanal, hexanal, 2-pentylfuran, 1-penten-3-ol, and 2-pentanone) from lipids. Furthermore, quality improvement (hardness and chewiness) due to texture changes after starter culture application during the manufacturing process are discussed.