For many years, natural products have been exploited to obtain extracts and pure substances, especially to treat various diseases and conditions. Bixa orellana, the seasoning and colouring known as “Achiote”, is used in several countries in traditional medicine to treat a variety of health needs, mainly using the dried pulp of the fruit, the seeds, the leaves and the roots. The objective of this review is to provide information regarding the numerous pharmacological activities of the different parts and extracts of B. orellana, such as the anti-inflammatory, anti-bacterial and anti-parasitic activity, as well as the hypoglycaemic, cytotoxic, antioxidant, bronchodilator, diuretic and hepatoprotective effects. This information will promote the development of further research regarding this plant and its various benefits, either in the form of an extract or pure substance, such as bixin and norbixin. Similarly, it will allow the discovery of its various mechanisms of action for each disease, which will promote the development of new active compounds.