Blueberries (Vaccinium sp.) have a long history of use in native and folk medicine in North America and Europe. Today the European blueberry (bilberry) is used in a variety of pharmaceutical and food supplement products that are recommended for treating blood vessel disorders and ophthalmological conditions. Anthocyanins, the pigments that impart the blue color to blueberries, are considered the active ingredient in bilberry health products, although other related flavonoids are biomedically useful. Vaccinium flavonoids are antioxidants and are also recognized for their anticarcinogenic properties and usefulness in treating urinary tract infections. The most immediate, and perhaps greatest, opportunity for a health market for North American blueberries may be in promoting blueberries as a healthy food. As researchers continue to explore the biomedical usefulness of blueberries, the blueberry food industry should strive to retain the healthful phytochemical in their products.