After consumption of anthocyanin-rich foods, there is a long journey before these bioactives may exert a health-promoting property. They must pass through the oral cavity, the gastrointestinal tract, undergo metabolism events, pass cellular barriers, and eventually trigger a biological event. Hence, before looking at the health effects of anthocyanins, some topics related to their food bioaccessibility, interaction with biomolecules (proteins, biomembranes, and DNA), and bioavailability/metabolism will be described as possible interferers to their bioactive effects. There are several reports on the health preventing properties of anthocyanins on several diseases like cardiovascular diseases, some types of cancers, diseases, diabetes, allergies and osteoporosis. In this chapter some of the less revisited ones giving emphasis to obesity/metabolic syndrome, microbiota modulation, neurodegenerative diseases and skin health will be reviewed.