Public health messages regarding seafood consumption are confounded by long standing dietary advice promoting the healthfulness of consuming fish and recent warnings concerning dangerous mercury levels in specified fish. The warnings vary by federal agency and are directed to vulnerable subpopulations, notably women of childbearing age, pregnant women, nursing mothers and young children. The issue of mercury in fish has received considerable media coverage, attention from consumer organizations and public policy review. The net result is an area of seemingly contradictory advice directed to consumers and health professionals on the type and quantity of fish safe to consume. This message that fish is nutritious and healthy is particularly understood by educated and affluent subpopulations who can afford a variety of fish in their diet. This review addresses the contradictory rhetoric and reviews the state and federal agency policy positions. It considers the arguments for and against disclosing mercury-related information and its anticipated impact on the extended health benefits of fish consumption versus the risk to vulnerable subpopulations. The issue of balancing and targeting healthy messages and dietary warnings on fish is important because within the U.S. childbearing population, it is conservatively estimated that 250,000 women may be exposing their fetuses to higher levels of methylmercury than is in federal public health guidelines; two million more may not be consuming enough low-mercury fish.