Abstract Fermented shellfish condiments are globally consumed especially among Asian countries. Condiments, commonly used as flavor enhancers, have unique sensory characteristics and are associated with umami and meaty aroma. The main reactions that occur during fermentation of shellfish include proteolysis by endogenous enzymes and microbial activities to produce peptides and amino acids. The actions of proteolytic enzymes and microorganisms (predominantly bacteria) are found to be largely responsible for the formation of taste and aroma compounds. This review elaborates different aspects of shellfish fermentation including classification, process, substrates, microbiota, changes in both physicochemical and biochemical components, alterations in nutritional composition, flavor characteristics and sensory profiles, and biological activities and their undesirable impacts on health. The characteristics of traditional shellfish production such as long duration and high salt concentration not only limit nutritional value but also inhibit the formation of toxic biogenic amines. In addition, this review article also covers novel bioprocesses such as low salt fermentation and use of novel starter cultures and/or novel enzymes to accelerate fermentation and produce shellfish condiments that are of better quality and safer for consumption. Practical Application : The review paper summarized the comprehensive information on shellfish fermentation to provide alternative strategies to produce shellfish comdiments that are of better quality and safer for consumption.