Heterocyclic amines (HAs) are a class of polycyclic aromatic compounds formed during thermal processing of aquatic products, exhibiting strong carcinogenic and mutagenic properties. Understanding the formation mechanisms and reduction strategies of HAs in heat-processed aquatic products is crucial for effectively enhancing food safety. This paper reviewed the distribution and formation mechanisms of HAs in heated aquatic products, focusing on factors influencing their generation, including the composition of aquatic products (amino acids, carbohydrates, fats, and metal ions) and processing conditions (methods, temperature, and duration). Current HA-reduction strategies in aquatic processing, such as pretreatment of raw materials, optimization of processing techniques, and addition of exogenous substances, were summarized. The mechanisms of these reduction strategies were discussed to provide theoretical guidance for improving the safety of heat-processed aquatic products.