In recent years, with the market scale of cross-border e-commerce imported food rapidly growing, cross-border e-commerce imported food has become one of the most purchased imported retail items. However, there are great potential food safety hazards in cross-border e-commerce imports. The current regulation of cross-border e-commerce imported food safety is faced with multiple dilemmas, including the dilemma of subject accountability caused by the flawed regulation system, the dilemma of safety control caused by imperfect risk management, the dilemma of information traceability caused by the complex trade mode, and the post-relief dilemma caused by limited social coordination. Therefore, it is highly required to improve the regulation system, innovate on the risk mechanism, stress empowerment through science and technology and coordinate social governance, so as to standardize the system of subject rights and responsibilities, eliminate the safety regulation defects, strengthen information traceability, guarantee relief and right protection in accordance with the law, and enhance the government’s capability to regulate cross-border e-commerce imported food safety.