The global rise in the emergence and spread of pathogens (bacteria, viruses, fungi, and parasites) that have developed or acquired new resistance mechanisms to drugs, commonly referred to as antimicrobial resistance (AMR) is alarming. The emergence and spread of AMR, which is mostly attributed to the use (often overuse and misuse) of antimicrobial substances such as antibiotics, is not a new phenomenon. In fact, AMR was discovered several decades ago. However, exponential increases in global antimicrobial use have led to a rise in the emergence and spread of AMR, which is nowadays considered as one of the top ten global public health threats by the World Health Organization (WHO). Antimicrobials, and in particular antibiotics, were first used in aquaculture practices in the 1950s, as a source to control bacterial infections. However, as in other food-producing sectors, the use of non-therapeutic antimicrobials in aquaculture (e.g. as prophylaxis treatments, to promote animal growth or as preservative to prevent fish and shellfish spoilage) becomes widespread soon after. The pervasive use of antimicrobials in aquaculture has facilitated the emergence and dissemination of antibiotic resistance worldwide, (1) by directly selecting for resistant pathogens within the aquaculture facilities, (2) by disseminating antimicrobial resistant microorganisms and genes through high levels of international trade of reared aquatic species, and (3) by allowing antimicrobials to enter freshwater and marine ecosystems, where they can select and transfer AMR genes to the wild populations and environment (i.e. water, sediment). In fact, aquatic environments, and in particular aquaculture inland facilities, are often considered as hotspots of AMR, since they may not only contribute to AMR emergence through antimicrobial use, but may accumulate and disseminate antimicrobial resistant microorganisms and genes coming from other AMR-contaminated sources (e.g. urban and agricultural effluents), amplifying AMR selection pressure. The aquaculture contribution to the global AMR pandemic has now been recognized by the WHO and other international organizations such as the Food and Agriculture Organization of the United Nations (FAO), and several efforts have been launched over the past decade to regulate antimicrobial use in aquaculture. Although structured and systematic surveillance efforts of AMR in aquaculture are still lacking, increasing scientific literature is revealing geographic aquaculture AMR hotspots, which may help in developing local targeted surveillance measures.