High-resolution spectroscopy (HRS) from the ground has become a great complement to space observations to study the composition and physical properties of exoplanets. Thanks to the ability to resolve molecular bands into individual lines and to measure their Doppler shift, it is particularly effective at detecting species and the orbital motion of exoplanets. I will show the working principles of the methodology and I will review recent highlights, among which the simultaneous detection of 6 molecular species and the measurement of elemental abundances (C/O ratio, metallicity) at precisions comparable to early JWST results. Future instrumental development, in particular the upcoming high- resolution spectrographs at the ELT, promise to extend the method to probe the atmospheres of terrestrial temperate exoplanets, and ultimately look for species potentially associated with biological activity.