More people in the world to feed, rising wealth and a new focus on healthy foods are generating a rising tide of demand for fish. This rise in demand is happening just when the main sources of fish and other aquatic life are struggling to keep pace, and prices of many aquatic commodities are increasing. Fish is caught from natural or wild fisheries stocks, from enhanced and restored fisheries stocks and is cultured on farms. All sources of supply present economic opportunities but each faces major problems. Most natural fish stocks are heavily depleted already, and continue to be over-exploited because fisheries management is inadequate to counter the drive to exploit. Aquaculture has made great progress in some countries, largely driven by markets and specific innovations but ignoring externalities such as the environment, feeds and social equity. Stock restoration and stock enhancement show promise for some species and some environments but have received little development attention. Whether the poor will rise on or submerge under the tide of fish demand depends on how affordable fish remains, and what access they have to the means of fish production for income and livelihood. Policy, technical and business solutions are needed to help the poor meet the challenges. The solutions are location and country-specific, but advances should be sought on three fronts: (1) domesticating key species for aquaculture production systems and selecting good candidate species for restoring and enhancing stocks in the wild, (2) making fish trade, development assistance and fisheries cooperation strategies coherent to enhance developing country capacity to capture equitable benefits of fish trade, and (3) managing natural fisheries resources to restore them and make them sustainable.