This study was carried to assess the risk associate with E. coli in marine fish in Port Sudan, Red Sea State, Sudan, through the production chain covering five stages. The stages were fish market, fish scaling, restaurant before cooking, and restaurant after cooking, and cooking and cooling for 24 h. A total of 50 fish samples were randomly selected from marine fish chain, in Port Sudan, Red Sea State, during the period from September to December 2018 to estimate the E. coli count using the TBX medium. In this study, the mean count of E. coli in the five stages of the fish chain was 257 +0.6 cfu. In fish market the mean was 247 +0.6 cfu, 758 +0.6 cfu in fish scaling stage, 283+0.6 cfu in restaurants before cooking, and 0.0 cfu after cooking and cooling for 24 hours after cooking. The chi-square test showed significant association between the load of E. coli among the fish chain and the most important potential risk factors (p-value ≤ 0.05), such as boxes cleaning (p-value= 0.000), hygienic practices (p-value= 0.002), waste disposal (p-value= 0.001), personal hygiene (p-value= 0.001), storage (p-value= 0.000) and general cleaning (p-value 0.002). The results of the frequencies of risk factors and their distribution in fish chain showed that 38% do not clean the boxes, 64% do not practice proper hygiene measures, 72% perform improper waste disposal, 72% had poor personal hygiene, 42% do not apply proper storage system, and 46% perform improper cleaning. All that will lead to medium overall risk estimation. Qualitative risk assessment for the E. coli in fish chain pathway was found to be high in the fish market and the exposure assessment in restaurant was found to be very low, so that the overall risk estimation for contamination with E. coli among the fish chain in Port Sudan was found to be Medium (The risky event is likely to occur more than once in the next three years).