An important aspect of food security is food safety, i.e., ensuring that food reaching consumers is safe and that consumers perceive the food to be safe. As Caribbean countries typically have hot and humid climates, there is the possibility that its food supply can be exposed to and become infected with harmful fungi. Mycotoxins are secondary metabolites of toxigenic fungi, which, if consumed in sufficiently large amounts, can have adverse effects on human health. In addition to being a risk to public health, uncontrolled mycotoxins in food supply can also temporarily or permanently harm Caribbean export and tourism markets. This review briefly examines the effects of mycotoxins on human health and focuses on culturally consistent, cost-effective and sustainable strategies that encourage local entrepreneurial engagement in the management of mycotoxins. These strategies may straddle the range of important mycotoxins examining mechanisms along the supply chain, recognizing the need for increased education and awareness, promoting local production and harmonizing food safety standards in the Caribbean.