Mercury is an important pollutant, released into aquatic ecosystems both naturally and by anthropogenic action. This element is transferred to aquatic organisms in different ways, causing potential health risks. In addition, mercury can be accumulated by humans, especially through the consumption of contaminated food. This systematic review aims to present mercury pathways, the major routes through which this element reaches the aquatic environment and its transformations until becoming available to living animals, leading to bioaccumulation and biomagnification phenomena. The key biotic and abiotic factors affecting such processes, the impact of mercury on animal and human health and the issue of seafood consumption as a source of chronic mercury contamination are also addressed. A total of 101 articles were retrieved from a standardized search on three databases (PubMed, Emabse, and Web of Science), in addition to 28 other studies not found on these databases but considered fundamental to this review (totaling 129 articles). Both biotic and abiotic factors display fundamental importance in mediating mercurial dynamics, i.e., muscle tropism, and salinity, respectively. Consequently, mercurial contamination in aquatic environments affects animal health, especially the risk of extinction species and also on human health, with methylmercury the main mercury species responsible for acute and chronic symptomatology.