The growing human population requires more food each year, and seafood products can help meet this demand if clean water resources are available for their growth. Farmed and wild mussels are environmentally friendly seafood with many health benefits to human consumers, but they can also pose a health risk if they are harvested from areas where marine anthropogenic pollution is uncontrolled or unmonitored. While the coastline in South Africa has long been assumed to be pristine, a growing number of recent studies are raising contamination concerns. Baseline studies establish a wide range of anthropogenic pollutants to be present in the marine environment, specifically in urbanised or industrialised areas like major cities or harbours. This review summarises how mussels could pose health risks to human consumers and the current research that is being conducted by private researchers and institutions in South Africa. The review emphasises the need for more research in the field and for governmental pollution monitoring data to be released to the public.