Prunus spinosa fruit, commonly known as blackthorn or sloe, possesses a wide range of health-promoting properties, including antioxidant and antibacterial activities. In this study, we investigated the effects of various extraction parameters, such as temperature, time, and solvent composition, on the extraction of bioactive compounds from P. spinosa fruit. Response surface methodology was employed to optimize these parameters and evaluate their impact on the antioxidant properties of the extracts. Furthermore, techniques such as ultrasound (US) and pulsed electric field (PEF) were applied, both individually and in combination, to explore their potential effects on the extraction process. The optimal extraction technique proved to be the combination of PEF and US, followed by stirring. The most suitable solvent was 75% ethanol, whereas the optimum extraction time and temperature were 30 min and 80 °C, respectively. Our findings revealed that under the optimum extraction parameters, a significant improvement in the extraction efficiency of bioactive compounds from P. spinosa fruit was achieved. More specifically, the optimal conditions, according to partial least squares (PLS) analysis, were a combination of all three extraction modes (PEF‒US‒ST), the shorter extraction time of the present study (30 min), and the corresponding higher temperature (80 °C). As expected, the presence of ethanol was considered necessary, even in an amount of 25%. The total polyphenol content was found to be 30.74 mg gallic acid equivalent (GAE)/g, the total flavonoids content 3.23 mg rutin equivalents (RtE)/g and the total anthocyanins 125.2 μg cyanidin-3-O-glucoside equivalents (CyE)/g. HPLC-DAD analysis showed that neochlorogenic acid was the polyphenol with the highest concentration (4.13 mg GAE/g) in P. spinosa fruit. The antioxidant activity of the optimized, according to PLS analysis, extract was evaluated and found to be 146.09 μmol ascorbic acid equivalent (AAE)/g determined by ferric reducing antioxidant power (FRAP) assay, and by the radical scavenging activity (DPPH) assay was 18.56 μmol AAE/g. Additionally, the ascorbic acid was determined to be 119.4 mg/100 g. Overall, this study contributes valuable insights into the extraction optimization process and the potential applications of P. spinosa fruit in the development of functional foods and pharmaceutical products.