This review presents an updated analysis regarding the application of ultrasound technology in fruits, vegetables and their derivatives. The relationship among structure, processing, the quantity and quality of nutrients and bioactive compounds are discussed. Initially, we discussed the effect of ultrasound processing on the structure of the matrices at tissues, cells and molecules levels, also considering the different factors that influence the reported responses. Subsequently, the effect on nutrients and bioactive compound quantity (concentration) and quality (bioaccessibility → bioavailability → bioactivity) is evaluated. Ultrasound processing resulting in tissues and cell disruption, fibre breakage, isomerisation, micellisation, among other modifications, improving the extractability of compounds and/or resulting in their degradation. Moreover, the obtained new matrix interacts differently with the human body, affecting the compound accessibility, which can be increased. In conclusion, different possibilities are discussed regarding using ultrasound processing to enhance healthy aspects of plant-based food products.