The world has come to acknowledge that the health and welfare of mankind is interconnected with the health and welfare of animals, plants and the environment as a whole. As such, the productivity, quality and safety of products derived from terrestrial or aquatic animal resources depends on the level of harmonious synchrony sustained between these components, the circular economy. This presents a paradox for the world’s rapidly aquaculture sector, that is rapidly growing and transforming while at the same time aquatic ecosystems are in a state of flux due to environmental and climate changes. The pivotal role played by aquatic ecosystems for life on earth, present key questions as the aquaculture sector seeks to transform into a sustainable yet resilient blue food system that contributes comprehensively to human welfare and SDG14 ‘Life Below Water’. The questions and opportunities at hand consequently infer that aquaculture need become intrinsic to One Health, as opposed the current situation where the application of One Health in aquaculture, is largely as an external intervention to safeguard the health, welfare and safety of farmed aquatic animals and their products for economic gain. Can the global status of information, knowledge, technology and training and education enable us achieve this?