Anthocyanins are natural plant pigments imparting red, blue, and purple colors to flowers, leaves, fruits, and some vegetables. In addition to fruits and vegetables baring these colors, other sources of intake include dietary supplements and natural colorants of food and beverages. Anthocyanins have a complex metabolic fate that includes extensive presystemic metabolism giving rise to a wide range of metabolites. Anthocyanins modify the expression and activity of cellular and tissue targets influencing various systems associated with health benefits, including anticancer, vascular, metabolic, and neuronal health. Assessments of anthocyanin safety and toxicology indicate that acute toxicity is very low in animals and there are no reports indicating adverse health effects in humans with consumption of anthocyanins at usual dietary intake levels. Currently, there is no recommended intake level of anthocyanins for optimal health or to avoid adverse effects; however, future research and continued consumer interest will undoubtedly present opportunities for pursing dietary guidance recommendations.