The aim of this review is to provide the first comprehensive analysis of the various technical and physical on-court demands in elite male handball with respect to playing positions. While low-intensity activities such as standing still and walking represent the greater proportion of playing time (up to ~70 %), handball can be considered an intense activity for all players, especially because of the large number of repeated high-intensity actions occurring throughout the game (e.g., jumps, sprints, changes of direction, duels, contacts). Additionally, the substantial number of body contacts likely increases neuromuscular load, both during and following games. However, the average running pace (53 ± 7 to 90 ± 9 m·min(-1)) during handball games tends to be lower than in the majority of other team sports, while blood lactate and heart rate responses tend to be similar and slightly lower, respectively. Behind these team-average data, the substantial variations in technical and physiological demands between the different positions have been overlooked in the literature. Whether physical fatigue actually occurs during games is still unclear since, in the majority of studies, games were not examined under actual competitive situations. We contend that, in practice, appropriate player rotations may allow players to maintain an optimal physical performance level or, at least, limit a possible drop in physical/playing efficiency. Future research should essentially focus on the technical and physiological responses during games in relation to specific collective systems of play and individual playing roles. The occurrence of player position-specific fatigue should also be better examined when considering individual playing time and rotation strategies.