Iron deficiency anemia (IDA) is a prevalent and serious nutritional health issue that can be mitigated through dietary iron supplementation. However, only ferrous ions, prone to oxidation, can be absorbed in the gastrointestinal tract. In the current work, the effects of high internal phase Pickering emulsions (HIPPEs) co-loaded with astaxanthin (ASTA) and ferrous gluconate on Fe2+ oxidation, IDA management, and their 3D printing performance were investigated. The results demonstrated that the HIPPEs co-loaded with ASTA and ferrous gluconate effectively reduced the oxidation rate of Fe2+ during storage. Animal studies also revealed that HIPPE co-loaded with ASTA and ferrous gluconate had a therapeutic effect on IDA symptoms in mice. HIPPE co-loaded with ASTA and 400 mg/L ferrous gluconate demonstrated superior efficacy in restoring hemoglobin (Hb) levels, organ coefficients, and histological parameters in mice with IDA. Moreover, the evaluation of the adaptability of HIPPEs co-loaded with ASTA and ferrous gluconate for food 3D printing indicated a slight reduction in printing resolution. Overall printing performance was found to be acceptable and satisfactory. Co-loading ASTA and ferrous gluconate in HIPPEs offers an efficient way to address the oxidation challenge of ferrous ion supplementation, enabling customization and flexibility in the production of iron-fortified foods to mitigate IDA.