The malaxation, a basic step of the mechanical olive oil extraction process, was studied by several authors, but a comprehensive investigation of its effects on the oil composition has not been accomplished yet. An effective olive paste malaxing is crucial in producing virgin olive oil (VOO) of exceptional quality. It is important to extract the optimum amount of oil, with the right quantities of antioxidants and the best possible flavour. The aim of this work is to present the state-of-the-art about malaxing technology and its influence on analytical parameters related to VOO quality, healthy and organoleptic characteristics of the product. Machinery evolution has been reported from the most traditional to the newest designs. Recent advances and future trends applied to the olive oil extraction technology are also reported.