Tetrodotoxin (TTX) poisoning caused by consumption of puffer fish is one of the major causes of death related to food poisoning in coastal areas of China. Tetrodotoxin poisoning occurs rapidly, and there are no specific antidotes at present. Therefore, detecting the content of TTX or identifying the species of puffer fish as a source of TTX is useful for better analysis, management and control of the risk of TTX poisoning. In this article, the detection techniques of TTX and the methods for species identification of tetrodotoxic fish are reviewed, which could be of great significance for preventing puffer fish poisoning and rational utilization of puffer fish resources, and future prospects are discussed. We hope that this review will help early warn and reduce food poisoning caused by puffer fish and promptly identify the cause after it happens.