Sambucus nigra has garnered attention in the food industry for its natural colouring and antioxidant properties, mainly due to its high content of anthocyanins, other polyphenols, and vitamins. These bioactive compounds not only contribute to the nutritional impact of food products, but also make it possible to replace synthetic additives that meet the current consumer demand for natural and functional foods. This study provides an overview of the bioactive compounds in Sambucus nigra (black elder) fruits, highlighting their potential health benefits and toxicity concerns. It examines the effect of different processing technologies on the phenolic and cyanogenic glycoside composition of elderberry, emphasizing the need to balance microbial decontamination with the sensory quality and nutritional value of food products. The study also reviews the mechanism of ultrasonic inactivation of microorganisms and the potential of fermentation to reduce toxic compounds in Sambucus nigra fruits, thus contributing to the improvement of food safety and nutritional quality, emphasizing the importance of considering the potential limitations of ultrasound and the use of combined methods to increase efficiency while minimizing the negative impact on both the product and the consumer. Additionally, the study discusses the significance of selecting appropriate processing methods to ensure the safety of elderberry products, given the presence of potentially harmful cyanogenic glycosides and lectins, which can be mitigated through heat treatment and fermentation.