Seahorse is a unique fish belonging to the genus Hippocampus. It has a horse-like head, tubular mouth, and the body is covered with rings of armoured plates until the tip of the prehensile tail. Seahorses are traded for human consumption and ornamental purposes. However, the dry product of seahorses has a major demand for traditional Chinese medicine (TCM). The ornamental products such as keychains, earrings and brooches also support a growing ‘curio’ trade. There is a limited amount of published data on seahorse distribution in Malaysia despite increasing pressure of exploitation, this study was carried out to review the available information, identify knowledge gaps and draw attention towards sustainability of the seahorse populations. To date, twelve seahorse species have been reported in Malaysia. Most of these species are found in East Malaysia. In Sabah, 11 out of 12 tropical seahorse species have been encountered. This does not include the Japanese dwarf seahorse, Hippocampus mohnikei. Among the eleven species of seahorses found in Sabah are seven species of common size seahorses, H. barbouri, H. comes, H. histrix, H. kelloggi, H. kuda, H. spinosissimus and H. trimaculatus and four species of pygmy seahorses, H. bargibanti, H. denise, H. satomiae and H. pontohi, that were previously identified as H. severnsi. This study highlights the importance of conservation of wild population of seahorses and the need for farming as a means of lessening the exploitation of wild stocks while meeting the human demand.