Sourdough bread, made from flour and water fermented by yeast and lactic acid bacteria, has gained popularity due to its enhanced nutritional profile and health benefits. This review discusses the factors influencing sourdough (SD) bread quality, including fermentation conditions, flour characteristics, and the use of alternative ingredients. SD fermentation improves bread quality by altering protein and starch structures, increasing dietary fiber, and reducing FODMAPs. It also enhances mineral bioavailability, reduces phytic acid, and degrades anti-nutritional factors. SD bread contains beneficial microbes and probiotics, which support gut health. Compared to yeast fermentation, SD bread has higher resistant starch, better digestibility, and a lower glycemic index. It also reduces acrylamide formation and increases antioxidant activity. SD fermentation affects protein functionality, starch behavior, and volatile compound profiles, influencing flavor and texture. Factors such as fermentation time, temperature, and SD type significantly impact bread quality. Flour particle size, protein content, and starch characteristics also play crucial roles in determining SD bread quality. The review highlights the potential of SD bread in the market, emphasizing its nutritional benefits and versatility in incorporating alternative ingredients. Overall, SD bread offers a healthier alternative to traditional bread, with unique sensory and nutritional properties.Sourdough bread, made from flour and water fermented by yeast and lactic acid bacteria, has gained popularity due to its enhanced nutritional profile and health benefits. This review discusses the factors influencing sourdough (SD) bread quality, including fermentation conditions, flour characteristics, and the use of alternative ingredients. SD fermentation improves bread quality by altering protein and starch structures, increasing dietary fiber, and reducing FODMAPs. It also enhances mineral bioavailability, reduces phytic acid, and degrades anti-nutritional factors. SD bread contains beneficial microbes and probiotics, which support gut health. Compared to yeast fermentation, SD bread has higher resistant starch, better digestibility, and a lower glycemic index. It also reduces acrylamide formation and increases antioxidant activity. SD fermentation affects protein functionality, starch behavior, and volatile compound profiles, influencing flavor and texture. Factors such as fermentation time, temperature, and SD type significantly impact bread quality. Flour particle size, protein content, and starch characteristics also play crucial roles in determining SD bread quality. The review highlights the potential of SD bread in the market, emphasizing its nutritional benefits and versatility in incorporating alternative ingredients. Overall, SD bread offers a healthier alternative to traditional bread, with unique sensory and nutritional properties.