Food sources of ellagitannins (ETs) are numerous, and dietary intake of these compounds is estimated up to 12 mg/day in some countries, even though ETs have been considered in the past as not bioavailable like other tannins and were mostly neglected by nutritionists. Nonetheless, new insights show that ETs are bioconverted by microbiota in the gut into metabolites called urolithins, which are bioavailable and can reach relatively high physiological concentration in the body up to 7 days after ingestion. According to the initial structure of ETs in the food source, the extent of bioconversion into urolithins may differ but all urolithins are susceptible to exert potential health benefits. Nonetheless, due to the intervention of microbiota, the production and excretion of urolithins are highly variable according to individuals, which have led to the classification of consumers into metabotype. According to metabotype, the potential health benefits of ellagitannins may differ among consumers. In in vitro, cellular and animal studies, numerous health benefits of ellagitannins and urolithins are reported mainly for the chemoprevention of hormone-dependent cancer and cardiovascular disease. Nonetheless, ellagitannins deserve closer attention from the scientific community to unravel more biological properties of this particular compound.