In recent years, a number of studies have clearly remarked the nutritional benefits of fish consumption: proteins, vitamins, minerals, and especially omega-3 polyunsaturated fatty acids (PUFAs), which may protect against several adverse health effects, including coronary heart disease mortality and stroke. However, some concerns about potential health risks derived from the environmental contaminants found in fish have been also raised. Therefore, balancing adequately the risks and benefits of fish consumption is currently a nutritional/environmental health key issue. In this paper, the most recent available scientific information concerning this issue is reviewed. It is concluded that although it seems evident that fish must be an important part of a balanced diet, to choose the most suitable species in terms of levels of PUFAs and pollutants, the frequency of consumption, and the meal size are essential aspects to balance benefits and risks of a regular consumption.