Multi-digit number processing is ubiquitous in our everyday life even in school, multi-digit numbers are computed from the first year onward. Yet, many problems children and adults have are about the relation of different digits (for instance with fractions, decimals, or carry effects in multi-digit addition). Cognitive research has mainly focused on single-digit processing, and there is no comprehensive review of the different multi-digit number processing types and effects. The current review aims to fill this gap. First, we argue that effects observed in single-digit tasks cannot simply be transferred to multi-digit processing. Next, we list 16 effect types and processes which are specific for multi-digit number processing. We then discuss the development of multi-digit number processing, its neurocognitive correlates, its cultural or language-related modulation, and finally some models for multi-digit number processing. We finish with conclusions and perspectives about where multi-digit number processing research may or should be heading in following years.