The risk of infection with Anisakis simplex and related parasites of fish has been recognized for some time, but it is now emerging that ingestion of material from dead parasites in food is also potentially dangerous. The resulting allergic reactions range from rapid onset and potentially lethal anaphylactic reactions to chronic, debilitating conditions. This review discusses the problems and clinical implications associated with A. simplex, other related conditions, and the way in which disease manifestations vary from person to person.