<p>The development of antioxidant-loaded extrudates has garnered global interest as a strategy to create nutritious, shelf-stable foods that combat oxidative stress-related diseases. This review examines the studies in formulating extruded food products enriched with diverse antioxidants and evaluates how extrusion processing parameters affect their stability and bioactivity. We discuss formulation techniques ranging from direct fortification with antioxidant-rich ingredients to advanced microencapsulation approaches that protect sensitive compounds during high-temperature extrusion. The influence of extrusion conditions on the retention of polyphenols, flavonoids, anthocyanins, carotenoids, and vitamins is critically analyzed, highlighting both losses of thermolabile compounds and counteracting effects like matrix release of bound phenolics and formation of Maillard reaction antioxidants. All types of extrudates are covered—cereal-based snacks and breakfast cereals, legume- or protein-based extrudates, composite flour extrudates, and even pasta—reflecting a global scope from Asia to Africa, Europe, and the Americas. Health-related findings from in vitro antioxidant assays, in vivo animal models, and limited clinical/consumer studies are compiled to elucidate potential functional benefits such as improved plasma antioxidant capacity, modulated gut microbiota, reduced markers of inflammation, and enhanced chronic disease risk factors. Consumer acceptance and sensory quality of antioxidant-fortified extrudates are also addressed. Overall, antioxidant fortification of extruded foods emerges as a promising avenue to deliver health-promoting compounds in convenient products, provided that formulation and processing are carefully optimized. Future research directions are identified, including the need for long-term human studies, improved encapsulation technologies, and scaling up the use of agro-industrial byproducts rich in antioxidants.</p>