The past decades have exhibited changes in the consumption of fresh fish. In developing countries, factors affecting fish consumption are different between urban and rural households. This study comparatively analyses the disparity in demand for fresh fish between rural and urban households in Cameroon. Using random sampling, data on the weekly consumption of fresh fish were collected between April and May 2015; 30 households lived in rural localities while 30 lived in urban areas of Buea Municipality. Consumer's income, the price of fresh fish, family size, gender and age of consumers represented parameters of interest. These were analyzed using the independent sample t-test. Results revealed that the availability, the income level and price affected fish consumption of rural dwellers while price, taste, income and affordability determined the consumption patterns of urban dwellers. The study equally revealed that the higher the price of fresh fish, the higher the demand for its closed substitutes and the higher the size of the household, the higher the quantity demanded. Gender, education and marital status did not affect the quantity demanded; family size and age negatively influenced consumers' decision to buy while consumers' income and price of fresh fish positively influenced consumers' weekly and monthly expenditure on fresh fish. The study proposes that more information be provided to consumers regarding the numerous nutritional benefits of fresh fish for both rural and urban dwellers. Also, policy makers and marketers need to improve the availability of fresh fish in rural and semi-urban settings.