The American cranberry (Vaccinium macrocarpon) has a rich history. A growing body of science now supports the role of the cranberry in maintaining urinary tract health. Although it has been commonly believed that cranberries promote urinary tract health by acidifying the urine, research best supports a mechanism of antiadhesion against certain urinary pathogens. New preliminary research suggests that this microbial antiadhesion effect may show promise in other parts of the body, including the oral cavity and gastrointestinal tract. A growing body of research suggests that cranberry is a relatively unique fruit because it may provide two different pathways to health: through microbial antiadhesion and broader benefits that may be related to antioxidant activities.