Sous-vide cooking has attracted considerable attention for its capacity to minimise nutritional and qualitative degradation in muscle foods, with research into the intricate changes in sensory attributes becoming a particular focal point. This paper presents recent insights into the sensory transformations of meat, especially shifts in texture, color, and flavour during sous-vide processing. Both cooking temperature and duration exert important influences, with temperature generally playing a more pivotal role across diverse conditions. The molecular mechanisms underlying the impacts of sous-vide cooking on muscle foods are comprehensively delineated. Notably, partial protein denaturation is a critical factor influencing textural changes. Compared with conventional thermal cooking, certain endogenous enzyme activities are retained during sous-vide processing. Furthermore, alterations in protein structure affecting water migration are crucial for meat juiciness. Flavour development is closely linked to lipid oxidation and its interplay with amino acids. To advance understanding in this domain, the application of mass spectrometry, omics, and other advanced analytical techniques is deemed imperative. This review provides comprehensive insights into the sensory and molecular changes occurring in meat during sous-vide cooking, which offer valuable guidance for researchers and industries to understand the underlying mechanisms and optimise culinary techniques in this domain.