Several studies have demonstrated the antioxidant and anti-inflammatory properties of anthocyanins, as well as their potential phytoestrogenic activity, which could have positive effects on human health. These compounds have shown effectiveness against conditions such as obesity, diabetes, and high cholesterol, which are known risk factors for cardiovascular diseases, including stroke. Stroke is currently the second leading cause of death globally, and cerebral small vessel disease (CSVD) accounts for 20% of all strokes, and it often causes cognitive impairment and gait abnormalities in older adults. Anthocyanins and their metabolites can cross the blood–brain barrier and affect signaling pathways, gene expression, and protein function at the molecular level. In addition to their ability to enhance vascular flow, anthocyanins can also help mitigate the risk factors associated with CSVD by counteracting oxidative stress in the body. These findings exploring the potential benefits of anthocyanins for individuals with CSVD. © The Author(s) 2024.