Anthocyanins are dietary bioactive compounds showing a range of beneficial effects against cardiovascular, neurological, and eye conditions. However, there is, as for other bioactive compounds in food, a high inter and intra-individual variation in the response to anthocyanin intake that in many cases leads to contradictory results in human trials. This variability could be caused at two levels, one at the bioavailability level and the other at the effect and mechanisms of action. In this context, we have thoroughly reviewed the scientific literature on anthocyanins variability caused by variation in bioavailability. Based on the literature reviewed, we have concluded that the variability in anthocyanins bioavailability might be produced by the lack of homogeneity introduced at three different levels: food matrix and food processing, enzymes involved in anthocyanin metabolism and transport, and anthocyanin metabolizing gut microbiota. However, it should be noted that the literature on anthocyanins bioavailability considering inter or intra-individual variability is still very scarce, which makes it difficult to reach any firm conclusion on the main metabolizing enzymes or bacteria that would be responsible for the variability in anthocyanin bioavailability.