Lutein belongs to oxygen-containing carotenoids and has various functional activity potentials such as antioxidant, preventing age-related macular degeneration (AMD), anti-inflammation, protecting cardio-cerebrovascular, anti-diabetes, and anti-cancer. However, it is typically consumed along with the food matrix, and its bioaccessibility is relatively low. Some food processing techniques have been developed to promote the release of lutein in plant-based foods and/or accelerate the decomposition of food matrix, which may damage the activity of lutein or reduce its bioaccessibility. By appropriately changing the food matrix and food processing methods, the functional characteristics of lutein in the diet can be enhanced. Therefore, this paper detailedly reviews the influence and action mechanism of lutein existence form and amount, food matrix structure and components, and food processing methods on the bioaccessibility and chemical interactions of lutein. Meanwhile, it also focuses on improving the bioaccessibility of lutein through the design of food matrix systems such as emulsions, hydrogels, molecular complexes, and liposomes, etc. This information will assist in selecting the suitable encapsulation system for commercial applications and provide a reference for increasing the bioaccessibility of lutein in food matrix.