Anthocyanins are naturally occurring polyphenolic pigments widely recognized for their antioxidant, anti-inflammatory, neuroprotective, and anticancer properties. Despite these promising bioactivities, their biomedical application is hindered by poor chemical stability and low bioavailability, especially under physiological conditions. Peptide-based delivery systems have recently emerged as a powerful approach to address these challenges by enhancing the stability, bioaccessibility, and functional efficacy of anthocyanins. This entry reviews the fundamental barriers limiting anthocyanin utilization and explores how peptide-based nanotechnology offers solutions. Emphasis is placed on the rational design of amphiphilic peptides—ranging from short synthetic oligopeptides to natural proteins like silk fibroin, sericin, and casein—that self-assemble with anthocyanins to form stable nanocomplexes. The mechanisms of interaction, particularly π–π stacking, hydrophobic association, and hydrogen bonding, are discussed in detail, supported by experimental and computational studies. Notably, peptides rich in aromatic amino acids such as tryptophan have shown superior binding and stabilization effects. This entry highlights key applications, including antioxidant therapy, wound healing, and oral delivery for chronic disease management. Case studies demonstrate that peptide–anthocyanin complexes significantly improve anthocyanin retention under stress conditions (e.g., heat, light, pH, and oxidation) and preserve or even enhance their biological activity. For example, silk-derived sericin hydrogels encapsulating anthocyanins promote wound healing by reducing oxidative damage and modulating cytokine expression. Importantly, these peptide-based systems show strong potential for managing chronic diseases and injuries associated with disability—such as neurodegenerative disorders, diabetic ulcers, and inflammatory joint conditions—by delivering anthocyanins more effectively to sites of tissue damage, thus supporting functional recovery and improving patient outcomes. Finally, this entry explores future directions such as leveraging computational design and machine learning to engineer next-generation peptide carriers with enhanced targeting and stability, alongside strategies for scalable, cost-effective production. Overall, peptide-based delivery systems are presented as a promising, biocompatible platform with broad applicability in both biomedical and functional food contexts, offering innovative solutions to overcome current limitations in anthocyanin utilization and to support therapeutic interventions, including those relevant to disability management.