Different maize (Zea mays L.) varieties have been used for thousands of years as a healthy food source in Mesoamerica including pigmented maize. Maize ingestion could contribute to the reduction in the rate of non-communicable diseases and, in turn, to its function as an adjuvant in their management. These diseases are mainly associated with oxidative stress, which is characterized by a redox cell imbalance produced due to pro-oxidant molecules accumulation, inducing irreversible damages. Although the endogenous antioxidant defense system is efficient, exogenous antioxidants are necessary to help to prevent this damage. Bioactive compounds, like anthocyanins, contained in dietary plants exert a major activity against oxidative stress. Could the maize anthocyanins play a curative, preventive or complementary role in the treatment of chronic diseases? Here, we describe the occurrence of anthocyanins from pigmented maize and their chemical structures. Furthermore, the biosynthesis, bioavailability, and stability are also summarized. Finally, many in vitro and in vivo studies of maize anthocyanins are discussed that demonstrated their nutraceutical potential, antioxidant capacity, and other biological effects. Given the importance of the biological properties of maize anthocyanins, it is necessary to understand the current knowledge and propose further research or clinical studies which allows us to better elucidate the biological mechanism of maize anthocyanins derivatives of several varieties and processes of cooking and combination with other ingredients to enhance their nutritional and health benefits.