Venomous creatures have been the source of much recent research in the effort to find novel physiological tools and pharmaceuticals. However, due to the technical difficulties with obtaining and storing venom extracts, the venoms of marine animals, particularly fish, remain a largely untapped source of novel compounds. The most potent effects of piscine venoms are on the cardiovascular system. All piscine venoms produce profound cardiovascular changes, both in vitro and in vivo, including the release of nitric oxide from endothelial cells, smooth muscle contraction, and differing effects on atria. Although there is a complex balance between different components of the venom response, similarities exist between the responses to the venoms of all species of fish. In addition to their cardiovascular effects, piscine venoms possess neuromuscular activity. Once again, the activities of most piscine venoms are very similar, usually consisting of a depolarising action on both nerve and muscle cells. Most piscine venoms have potent cytolytic activity, and it seems likely that this activity is the mechanism behind many of their cardiovascular and neuromuscular effects. Piscine venoms all seem to share similar activity, probably as a result of evolving for a common purpose, and cross-reactivity with stonefish antivenom, both functionally in experimental models and in Western immunoblotting analysis, suggesting that piscine venoms may also possess structural similarities in addition to their functional similarities.