Fermented foods (ffs) and beverages are widely consumed in Southeast Asia (SEA) for their nutritional balance, flavor, and food security. They serve as vehicles for beneficial microorganisms performing a significant role in human health. However, there are still major challenges concerning the safety of ffs and beverages due to the presence of natural toxins. In this review, the common toxins found in traditional ffs in SEA are discussed with special reference to mycotoxins and plant toxins. Also, mitigation measures for preventing risks associated with their consumption are outlined. Ochratoxin, citrinin, aflatoxins were reported to be major mycotoxins present in SEA ffs. In addition, soybean-based ff food products were more vulnerable to mycotoxin contaminations. Common plant toxins recorded in ffs include cyanogenic glycosides, oxalates, phytates and saponins. Combined management strategies such as pre-harvest, harvest and post-harvest control and decontamination, through the integration of different control methods such as the use of clean seeds, biological control methods, fermentation, appropriate packaging systems, and controlled processing conditions are needed for the safe consumption of indigenous ffs in SEA.