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Concerns about fresh food quality have continuously increased in recent years. Reducing the spoilage and loss of fresh foods and ensuring their safety for consumption are of great significance to facilitating the high-quality development of the food industry and meeting people’s growing needs for a better life. Active composite packaging films have demonstrated remarkable efficacy in enhancing the quality of fresh foods. Metal nanoparticle-polymer composite films can inhibit microbial growth and metabolism, slow down the oxidation process of foods, and reduce harmful substances in the storage microenvironment, thereby improving the safety of foods and finally extending the shelf life. As such, active composite packaging films have become a research hotspot in the field of food preservation. This review first summarizes the fabrication strategies and characteristics of metal nanoparticle-polymer composite films. Subsequently, a comprehensive analysis of the mechanism of food preservation by the composite films is conducted from the aspects of antibacterial effect, antioxidant effect, ethylene removal, and high barrier properties. Additionally, the sensing function and biosafety of the composite films are explored. Finally, the current challenges for the application of the composite films are elaborated, and an outlook on future opportunities is provided with a view to promoting the research and application of composite films in the field of fresh food packaging.