Background: Synthetic colors are prevalent in modern food processing, with Chocolate Brown HT (E155) being widely used to meet the demand for chocolate colors. This study examined the long-term health effects of E155 on both male and female subjects. Methods: Six treatment groups received E155 in low to high dosages (200, 400, and 600 mg/kg body weight) for 40 weeks, while control groups consumed a normal diet. After the feeding period, biochemical and histological evaluations were conducted alongside regular physical observations. Results: The female high-dose (FHD) group exhibited the most significant decrease in body weight. Body Mass Index (BMI) dropped notably in females at moderate (FMD) and high doses (FHD). Serum levels of cholesterol, LDL, and triglycerides increased dose-dependently, with males being more susceptible. Elevated SGPT and SGOT levels indicated liver function impairment due to E155. Both genders showed centrilobular necrosis and fibrosis at high doses, with immune cell invasion even at low doses. Serum creatinine levels, especially in males, were significantly elevated. Females experienced severe injuries, including arteriolar hyalinosis at low doses and IgA nephropathy in the FHD group. Conclusion: The findings underscore serious public health concerns regarding the long-term intake of E155, which can cause significant hepatic and renal damage, particularly in females. This highlights the need for regulatory review and potential restrictions on the use of E155 in food products.