Foxtail millet prolamin, one of the major protein constituents of foxtail millet, has garnered attention due to its unique amino acid composition and function. Foxtail millet prolamin exhibits specific physicochemical and functional characteristics, such as solubility, surface hydrophobicity, emulsifying, and foaming properties. These characteristics have been exploited in the preparation and development of products, including plant-based alternative products, nutritional supplements, and gluten-free foods. Additionally, because of the favorable biocompatibility and biodegradability, foxtail millet prolamin is frequently used as a carrier for encapsulation and targeted delivery of bioactive substances. Moreover, studies have shown that foxtail millet prolamin is highly nutritious and displays various biological activities like antioxidant effects, anti-inflammatory properties, and anti-diabetic potential, making it a valuable ingredient in medicinal products and contributing to its potential role in therapeutic diets. This review summarizes the current knowledge of the amino acid composition and structural characteristics of foxtail millet prolamin, as well as the functional properties, biological activities, and applications in functional food formulation and drug delivery strategy. Challenges and future perspectives for the utilization of foxtail millet prolamin are also pointed out. This review aims to provide novel ideas and broad prospects for the effective use of foxtail millet prolamin.