The demand for health-promoting food ingredients rises within an increasing market worldwide. Different milks fermented with bacteria, yeasts, moulds or enzymes from animal, plant and microbial sources offer a broad range of possibilities to cover different health aspects with new bioactive components. By the fermentation process interesting ingredients are enriched and released from the matrix, like lactoferrin, micro-nutrients, CLA and sphingolipids or synthesized, such as exo-polysaccharides and bioactive peptides. In particular, milk derived bioactive peptides exert several important health-promoting activities, such as anti-hypertensive, anti-microbial, anti-oxidative, immune-modulatory, opioid and mineral-binding properties. Milk-fermentation processes with probiotic bacteria synergistically combine health supporting bacterial and milk ingredient aspects which include new therapeutic solutions concerning hypercholesterolemia, carcinogenic intoxications, treatment of diarrhea, reduction of intestine pathogens, and supporting natural immune defense. Especially, milk-proteins and associated bioactive peptides released during microbial or enzymatic fermentation of milk offer a broad spectrum of new functional properties, for instance anti-hypertensive, anti-microbial, anti-oxidative, immuno-modulatory, opioid and mineral-binding properties. This review aimed at discussing recent research activities on physiological purposes and technical process aspects of functional components from fermented milk with a specific focus on biofunctional peptides released from fermented milk proteins.