Natural pigments from plants are of growing interest as substitutes for synthetic dyes in the food and pharmaceutical industry and they increase their added value if they possess positive effects on health. These pigments can be added as such if they are in the legal authorized lists of additives or can be added as phytochemical-enriched plant extract achieving the original product, which has received it, the new nomenclature of functional food. In this way, we comprise on this review a wide point of view of a group of natural pigments known as betalains. From a chemical point of view, betalains are ammonium conjugates of betalamic acid with cyclo-DOPA (betacyanins, violet) and aminoacids or amines (betaxanthins, orange or yellow), which are compounds present in our diet. Besides and taking into account that one type of betalain, betanin is approved as food colorant (E-162) by the European Union and that enlarges the specific weight of these compounds in the diet, we have evolved an overview from the biosynthesis, technology and promoting production, industrial uses as pigments up to physiological and nutritional biovailability or biological and health-promoting properties of betalains for accessible information to industrials, researchers and consumers.