Proanthocyanidins (PAs) are a class of polymers composed of flavan-3-ol units that have a variety of bioactivities, and could be applied as natural biologics in food, pharmaceuticals, and cosmetics. PAs are widely found in fruit and vegetables (F & Vegs) and are generally extracted from their flesh and peel. To reduce the cost of extraction and increase the number of commercially viable sources of PAs, it is possible to exploit the by-products of plants. Leaves are major by-products of agricultural production of F & Vegs, and although their share has not been accurately quantified. They make up no less than 20% of the plant and leaves might be an interesting resource at different stages during production and processing. The specific structural PAs in the leaves of various plants are easily overlooked and are notably characterized by their stable content and degree of polymerization. This review examines the existing data on the effects of various factors (e.g. processing conditions, and environment, climate, species, and maturity) on the content and structure of leaf PAs, and highlights their bioactivity (e.g. antioxidant, anti-inflammatory, antibacterial, anticancer, and anti-obesity activity), as well as their interactions with gut microbiota and other biomolecules (e.g. polysaccharides and proteins). Future research is also needed to focus on their precise extraction, bioactivity of high-polymer native or modified PAs and better application type.