Carotenoids are natural pigments that provide many health benefits to living organisms. Although terrestrial plants are the major dietary source of carotenoids for humans, aquatic animals (especially fish and shellfish) are equally important because they are rich in certain important carotenoids lacking in fruits and vegetables. Although extensive research has focused on exploring the carotenoid content and composition in fish and shellfish, this information is poorly organized. This paper reviews the scientific evidence for the carotenoid content and composition in fish and shellfish. It makes serious attempts to summarize the relevant data published on specific research questions in order to improve the understanding of various evidence to clarify the research status of carotenoids in fish and shellfish and defining topics for future studies. From the analysis of published data, it is obvious that most fish and shellfish are rich in complex carotenoids (e.g. astaxanthin, fucoxanthin, fucoxanthinol, lutein). These carotenoids have stronger antioxidant effect, higher efficiency in removing the singlet oxygen and the peroxyl radicals, and have a variety of health benefits. Carotenoid levels in fish and shellfish depend on genotype, climatic conditions of the production area, storage and cooking methods. However, the information of the bioavailability of fish/shellfish carotenoids to human is very limited, which hinders the actual contributions to health. The findings of this study can be used as a guide to select appropriate fish and shellfish as dietary sources of carotenoids, and provide information about potential fish and shellfish species for aquaculture to produce carotenoids to meet part of the growing demand for natural carotenoids.