The primary purpose of this review was to examine fish production, aquaculture development, marketing, post-harvest practices, and consumption trends, along with key challenges facing the fisheries and aquaculture sub-sector in Ethiopia. The study also explored the enabling policy and institutional environment, with particular focus on integrating the sector within national agriculture, nutrition, and food security strategies. A mixed-methods approach was used to synthesize findings from both qualitative and quantitative data sources. An extensive literature review was conducted on empirical studies related to aquaculture development, inland capture fisheries, post-harvest handling and technology dissemination, fisheries economics, and regulatory frameworks. The fisheries and aquaculture value chains were analyzed using a unique cross-sectional dataset from major Ethiopian water bodies, including reservoirs and lakes in the Rift Valley and highlands such as lakes Chamo, Tana, Ziway, Koka, and Hawassa. In addition, time series data on fish and fishery product imports and exports, as well as price trends by product type, were compiled from the Ethiopian Revenue and Customs Authority, the Ministry of Agriculture, and the World Trade Map. The Living Standards Measurement Study (LSMS) dataset from the World Bank was used to assess changing patterns in fish consumption across income quintiles and regional states. Comparative insights into aquaculture practices and the fish marketing and regulatory environment were drawn from IGAD countries, particularly Uganda and Kenya. The study also provides mid-term projections on Ethiopia’s fish demand and supply outlook, and highlights opportunities to scale aquaculture as a sustainable solution for improving nutrition and livelihoods.