This review on ciguatera fish poisoning contains information on the ciguatera intoxication syndrome and the provoking ciguatoxins (CTXs) and gambiertoxin-4b (GTX-4B), of which CTX-1 is a major component at the end of food chain (the carnivore fish). Data on chemical structures and detection methods of ciguatoxin (CTX), sources for CTX, marine organisms associated with CTX, toxicity of CTX for animals and man, possible preventive measures for ciguatera intoxication, case reports of outbreaks of ciguatera intoxication and regulations and monitoring of CTX are included. Finally some recommendations are given for a better control of the putative CTX problem in the future.