Milk pasteurization and sterilization by heat treatment have an exciting history, which followed steady steps. The main aim of these treatments is to extend the shelf life of milk by destroying pathogenic and milk spoilage bacteria. With developments in pasteurization techniques, the assurance of milk safety, and extended shelf life, pasteurized bovine milk has become a staple food, especially in Western diets. However, some concerns have recently been raised about the effect of pasteurization on the sensory properties and nutritional quality of milk, and alternative methods, such as high-pressure processing, are being investigated. The primary purpose of milk pasteurization and sterilization is summarized in this review article. The associated changes that affect the compositional, sensory, and nutritional quality of milk are discussed, with particular emphasis on protein structure and function. The review is concluded by considering alternative methods, their advantages and limitations, along with future prospects.