Consumption advice to ensure the health and safety of fish consumers remains urgent to handle the ever-increasing panic over heavy metal toxicity. Moreover, studies of fish consumption rarely focus on the perceptions and awareness of consumers. Considering this, the present study examines the knowledge and perceptions of the risks and benefits of fish consumption among consumers of Laguna de Bay to explore their willingness to follow fish consumption advice. The seasonal variation in selected types of heavy metal contamination in two commercially important fish species, tilapia and mudfish, was analysed and a vulnerability map based on the risk‒benefit ratio was produced for Laguna de Bay. Furthermore, this study formulates fish consumption advice for consumers of fish in the area. Primary data on consumers’ perceptions were collected through a questionnaire, whereas heavy metal contamination data were compiled from the best available literature. We concluded that people’s willingness to adopt consumption advice is mostly dependent on their existing level of fish consumption. Moreover, consumption advice is formulated to indicate restrictions on consumption for the areas identified as vulnerable due to contamination. This empirical study can serve as a model for the future development of fish consumption advice in the region.