This review aims to highlight some aspects regarding anthocyanins bioavailability. Although there is a considerable variability in the values for the biokinetic parameters, anthocyanins appear to be rapidly absorbed and eliminated, reaching low maximal concentrations in plasma and urine. Nevertheless, some works have reported a high content of intact anthocyanins in plasma, possibly resulting from gastric absorption. So far, no anthocyanin metabolites have been detected in the stomach and the possible mechanism of anthocyanin gastric absorption is still unknown. Some progress in this field is expected to be obtained through studies involving a new human cell culture model of the gastric surface suitable for bioavailability screening of nutraceuticals like anthocyanins and anthocyanin-derived pigments. The positive health effects associated with anthocyanin consumption could derive from the contribution afforded by the stomach to intact anthocyanin absorption. Nonetheless, these latter may be further metabolized to other bioactive forms.