Anthocyanins are a group of natural occurring pigments responsible for the red-blue colour of many fruits and vegetables. Anthocyanins are of interest for two reasons because they cannot only be used in the technological field as natural colorants but also have important implications in the field of human health. Numerous studies indicate the potential effect that this family of flavonoids may have in reducing the incidence of cardiovascular disease, cancer, hyperlipidemias and other chronic diseases through the intake of anthocyanin-rich foods. This review examines existing literature in this area: from plant content and distribution to health implications, including the effect of agronomic and genetic modifications on the anthocyanin content of plants as well as other biotechnological factors and food processing. The bioavailability, metabolism, bioactivity, and epidemiology of anthocyanins will also be reviewed.