The substitution of petroleum-based synthetic polymers in latex formulations with sustainable and/or bio-based sources has increasingly been a focus of both academic and industrial research. Emulsion polymerization already provides a more sustainable way to produce polymers for coatings and adhesives, because it is a water-based process. It can be made even more attractive as a green alternative with the addition of starch, a renewable material that has proven to be extremely useful as a filler, stabilizer, property modifier and macromer. This work provides a critical review of attempts to modify and incorporate various types of starch in emulsion polymerizations. This review focusses on the method of initiation, grafting mechanisms, starch feeding strategies and the characterization methods. It provides a needed guide for those looking to modify starch in an emulsion polymerization to achieve a target grafting performance or to incorporate starch in latex formulations for the replacement of synthetic polymers.