As aquaculture production and the consumption of aquaculture products increase, the possibility of contracting zoonotic infections from either handling or ingesting these products also increases. The principal pathogens acquired topically from fish or shellfish through spine/pincer puncture or open wounds are Aeromonas hydrophila, Edwardsiella tarda, Mycobacterium marinum, Streptococcus iniae, Vibrio vulnificus and V. damsela. These pathogens, which are all indigenous to the aquatic environment, have also been associated with disease outbreaks in food fish. Outbreaks are often related to management factors, such as the quality and quantity of nutrients in the water and high stocking density, which can increase bacterial loads on the external surface of the fish. As a result, diseased fish are more likely to transmit infection to humans. This review provides an account of human cases of zoonoses throughout the world from the principal zoonotic pathogens of fish and shellfish.