Starch occurs as highly organized structures, known as starch granules. Starch has unique thermal properties and functionality that have permitted its wide use in food products and industrial applications. When heated in water, starch undergoes a transition process, during which the granules break down into a mixture of polymers-in-solution, known as gelatinization. The sequence of structural transformations that the starch granule undergoes during this order-to-disorder transition has been extensively researched. None of the published starch gelatinization theories can fully and adequately explain the exact mechanism of sequential structural changes that starch granules undergo during gelatinization. This chapter analyzes several published theories and summarizes our current understanding of the starch gelatinization process.