BACKGROUND: The metabolic syndrome (MetS) can lead to fatal complications including cardiovascular disease. Evidence has emerged that increased fruit and vegetable intake and decreased intake of saturated fats, simple sugars, and processed foods can improve cardiovascular health. Anthocyanins (color pigments) have anti-inflammatory and antioxidant capacities but are of low bioavailability. AIMS: This systematic review and meta-analysis investigated the possible beneficial effects of the intake of berries high in anthocyanins on MetS risk factors. High-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol (TC) were investigated. METHODS:. 2,274 articles were identified from PUBMED and EMBASE following a search input that was designed to include studies of interest, 21 of these were included RESULTS: The studies showed an overall reduction in low-density lipoprotein (p = 0.04). Increases in HDL were found with cranberry and freeze-dried berry intake during a 4-6-week intervention. No significant findings were detected for fasting glucose, Hb1Ac, insulin levels, blood pressure, oxidized LDL (OX-LDL), BMI, and overall HDL. CONCLUSIONS: We concluded that the results presented in this systematic review and meta-analysis support current evidence that increased berry intake improves MetS key risk factors and reduces the risk of cardiovascular disease. Pronounced effects were apparent for concentrated berry products, such as freeze-dried strawberries.