Hematology can be a useful tool for monitoring health status, detecting illness, and following the progress of disease and response to therapy. Despite advances in fish medicine in recent years, interpretation of fish hematology often is hampered by a lack of meaningful reference values and the bewildering diversity of fish species. A multitude of intrinsic and extrinsic factors cause normal and abnormal variation in hematologic data. This article provides an overview of some of the hematologic abnormalities in fish induced by infectious agents and environmental, husbandry, and nutritional issues.