To review history, biology, and medical aspects associated with fish and shellfish poisoning.Current literature, various Web sites, and Halstead's Volume II of Poisonous and Venomous Marine Animals.Determined by author.Determined by author.Fish and shellfish poisoning occur through the natural event of the food chain. Fish and shellfish consume algae that contain toxin-producing dinoflagellates. As a result they become contaminated and the toxin is concentrated as it moves up the food chain. Fish and shellfish can tolerate high levels of toxins, thereby appearing healthy while posing a significant danger to man. The toxin cannot be detected by sight, smell, or taste and is not destroyed by cooking or freezing. Thus man becomes an unsuspecting victim. There are several types of poisoning that occur through fish and shellfish consumption. They are ciguatera and scombroid fish poisoning; and paralytic, diarrheic, neurotoxic, and amnesic shellfish poisoning. A different toxin produces each of these poisonings; however, sources and symptoms may be similar among these poisonings making them difficult to diagnose. These intoxications can vary in severity from mild to fatal depending on the type and amount of toxin ingested. Age and underlying illnesses may also contribute to the outcome of these poisonings.Though people are aware of health warnings and may think they are important, it is human nature to think that "this could not possibly happen to me". Therefore, they fail to make the necessary changes required to reduce the incidence of fish and shellfish poisoning.