Fish harbor a variety of bacterial pathogens, some of which can cause disease in humans. Zoonotic bacteria that may be present in asymptomatic fish hosts pose a public health risk when transmitted to humans through handling or consuming infected fish. Mycobacteriosis, caused by species in the Mycobacterium marinum group, is perhaps the most notorious zoonotic infection associated with fish and can produce serious skin infections in humans. Streptococcosis and staphylococcosis also occur with some frequency in fish and can result in human cases of septicemia, endocarditis or pneumonia if injured skin comes into contact with infected fish tissues and bacteria access wounds. Additionally, some Vibrio and Clostridium species found among fish may cause wound infections or gastrointestinal illness in humans, usually subsequent to exposure through handling or ingesting raw seafood. Clinical signs of bacterial zoonosis are variable and diagnosis in human cases can prove complicated by the vast diversity of potential pathogens involved. Preventative measures center on educating aquarists and fish handlers to avoid direct contact with ulcerated areas, lesions or feces from diseased fish. For consumer safety, good aquaculture practices that reduce bacterial loads in farmed fish stock are recommended. Moreover, thoroughly cooking fish to an internal temperature over 140°F destroys pathogens that may be present. Additional research priorities include better characterization of bacterial diversity among wild and farmed fish, investigating genetic and immunological aspects of disease resistance, developing improved diagnostics through genomic analysis, assessing efficacy of existing antibacterial treatments in clearing pathogens prior to human consumption and formulating integrated control strategies to mitigate risks. This book chapter examines the incidence, transmission mechanisms and pathologic implications of common bacterial zoonosis originating from fish hosts.