Aquatic foods, particularly fish, are recognized as a unique source of essential fatty acids, micronutrients and protein many diets lack, especially in poor and vulnerable communities. Tilapia (Oreochromis sp.) fillets typically represent 30%-33% of the fish, leaving around 70% of the fish unused for human consumption. These nutrient-rich by-products can be converted into food and other products with medical, pharmaceutical and packaging applications. Heads and backbones of processed tilapias, and undersized tilapia can be used in the development or fortification of food products such as fish cakes, sausages and bread. Tilapia skin can be processed into leather for clothing and leather artefacts. Gelatin from fish skin can be developed into edible films and coating while collagen from fish scales and bones has good application in the cosmetic and pharmaceutical fields. The viscera can be converted into biodiesel or silage and hydrolysates, which are good sources of peptides and enzymes. To ensure 100% utilization, any remaining parts of the fish not used for food, can be transformed into products for animal consumption or for fertilizer. Thus, the conversion of by-products from tilapia processing into value-added products can contribute to improve human nutrition and better livelihood opportunities. However, adopting new technologies in value addition will require additional operational costs for acquiring new equipment and skills, a proven market demand for the products and an enabling policy environment.