Introgression of spontaneous or induced mutations has been used to increase the levels and diversify the profile of antioxidants in many fruits including tomato. The high-pigment (hp) and old-gold (og) alleles exemplify this approach as attractive genetic resources suitable to inbred elite high-lycopene (HLY) tomato lines with improved color and nutritional attributes. Although several studies have been published on HLY tomatoes, a systematic analysis of the information on their agronomic performances, processing features, and functional quality is lacking, leaving room for the assumption of their poor competitiveness with conventional tomato cultivars and limiting their agricultural diffusion. Therefore, the aim of this study is to critically review the most important agronomic, horticultural, and functional traits of HLY tomatoes, as well as the advances in some emerging (pre)industrial applications. Field experiments performed in different countries showed that most available HLY lines are productive, vigorous, with excellent foliage cover and with morphologically acceptable fruit. Tomato yield of HLY genotypes ranged from ∼30 to ∼178 t/ha exceeding, in some trials, that of highly productive cultivars. Red-ripe fruits of most HLY lines showed commercially suitable soluble solids and titratable acidity, in addition to increased levels of lycopene (up to 440 mg/kg fw) and other bioactive phytochemicals (mainly flavonoids and vitamin C) compared to their near isogenic conventional counterparts. Innovative (pre)industrial uses of HLY tomato include the following: (1) production of HLY sauces, juices, and powders; (2) supercritical-CO₂ extraction of lycopene containing oleoresins; and (3) preparation of lycopene rich micro- and nano-carriers with improved stability and specific tissue delivery. In turn, the use of these innovative high-quality ingredients in the formulation of lycopene fortified foods, cosmetic products, nutraceuticals, and pharmaceuticals has been proposed as the basis of a novel highly profitable tomato product chain.