The field of fish pathology has traditionally been challenging, with many fish diseases presenting with similar symptoms and pathologies. However, advances in modern technology have revolutionized the diagnosis and treatment of fish diseases, allowing for more accurate and effective management of fish health. In this article, we review the latest advances in fish pathology, including molecular diagnostic techniques, advanced imaging technologies, novel therapeutics, and automated systems that monitor water quality and feed intake. We also discuss the potential of artificial intelligence (AI) and machine learning (ML) algorithms in predicting disease outbreaks and optimizing treatment strategies in real time. Finally, we examine the challenges that remain in the field of fish pathology, including the need for a multi-disciplinary approach to diagnosis and treatment and the risk of contributing to antibiotic resistance and environmental problems through the use of antibiotics and other chemical treatments.