You can eat sushi while pregnant, but it needs to be made with cooked seafood or vegetables rather than raw fish. The core concern is that raw and undercooked fish can carry parasites and bacteria, including listeria, which can cause miscarriage, stillbirth, or serious infections in newborns. The good news: plenty of delicious sushi options are fully cooked and safe.
Cooked Sushi Rolls That Are Safe
Any sushi roll made with cooked, low-mercury seafood is fine to eat during pregnancy as long as the fish has been heated to 145°F. Some of the most common options you’ll find on a menu include:
- California roll: typically made with imitation crab (surimi), which is pre-cooked and made from low-mercury fish
- Ebi roll: cooked shrimp
- Unagi roll: cooked freshwater eel, always served grilled
- Spicy crab roll: usually made with cooked crab or imitation crab
- Spicy shrimp roll: cooked shrimp with spicy mayo
- Tempura rolls: deep-fried shrimp or vegetables
Vegetable rolls are also completely safe. Avocado rolls, cucumber rolls, sweet potato rolls, and inari (seasoned tofu skin) are all good choices that sidestep the seafood question entirely.
One important thing to do: always ask what’s actually in the roll. Restaurants sometimes add raw fish alongside the cooked ingredients, so a “shrimp roll” might also contain raw tuna. A quick question to your server clears this up.
Why Raw Fish Is Off Limits
The FDA advises pregnant women to avoid all raw or undercooked finfish and shellfish, including traditional sashimi and nigiri made with raw fish. Raw seafood is more likely to contain parasites and harmful bacteria than cooked seafood, and pregnancy makes you more vulnerable to foodborne illness because your immune system is naturally suppressed.
Listeria is the biggest worry. Unlike most bacteria, it can grow even in refrigerated food. Listeriosis during pregnancy can cause miscarriage, stillbirth, preterm labor, and serious infections of the blood or brain in newborns. The consequences are severe enough that the American College of Obstetricians and Gynecologists specifically states: do not eat sushi made with raw fish.
You might hear that sushi-grade fish in the U.S. is flash-frozen to kill parasites. The FDA does require that fish intended to be eaten raw be frozen at -4°F for seven days, or at -31°F until solid and stored for 15 to 24 hours. This process kills parasites effectively, but it does not eliminate bacteria like listeria or salmonella. Freezing addresses one risk, not all of them.
Fish to Avoid Entirely, Even Cooked
Mercury is the second concern, separate from whether fish is raw or cooked. Some fish accumulate so much mercury that they’re unsafe during pregnancy regardless of preparation. The FDA says to completely avoid these seven types:
- King mackerel
- Marlin
- Orange roughy
- Shark
- Swordfish
- Tilefish (from the Gulf of Mexico)
- Bigeye tuna
Bigeye tuna is the variety most commonly served as raw tuna in sushi restaurants, so even if you were considering cooked tuna rolls, it’s worth asking which species is being used.
Low-Mercury Fish for Sushi
If you’re ordering cooked sushi or asking a restaurant to prepare fish fully cooked, plenty of low-mercury options work well. Salmon, shrimp, crab, squid, scallop, freshwater trout, cod, clam, and octopus are all in the FDA’s “best choices” category for mercury. You can safely eat up to two 6-ounce servings per week of these lower-mercury varieties.
Albacore (white) tuna is a middle-ground fish. It’s not on the “avoid” list, but it contains more mercury than lighter varieties, so the Mayo Clinic recommends capping it at 6 ounces per week. Canned light tuna, which is typically skipjack, has lower mercury levels and is considered a safe choice within the standard two-servings-per-week guideline.
Imitation Crab and Surimi
Imitation crab, the ingredient in most California rolls, is made from processed whitefish that’s been cooked during manufacturing. It’s safe to eat during pregnancy. Just confirm there are no raw ingredients mixed into the roll alongside it. If you’re eating a California roll from a reputable restaurant, you’re generally fine.
What About Smoked Salmon Rolls
Cold-smoked salmon (the silky, translucent kind used in many sushi rolls) is not fully cooked and carries a listeria risk. The NHS specifically warns against cold-smoked or cured fish during pregnancy unless it’s been heated until steaming hot. If a roll contains smoked salmon that hasn’t been cooked through, treat it the same as raw fish and skip it.
Seaweed and Nori
The nori wrapped around your sushi roll is safe and provides iodine, which is important during pregnancy. Seaweed snacks are fine in moderation too, though you’ll want to choose lower-sodium versions when possible. One type to avoid entirely is hijiki seaweed, which contains high levels of inorganic arsenic. Kelp is extremely iodine-dense, so if you eat it, keep portions small and infrequent, no more than once a week.
Ordering Sushi Safely
Eating sushi while pregnant doesn’t have to mean giving up your favorite restaurant. It just means shifting what you order. Stick with rolls that are fully cooked, ask about hidden raw ingredients, and choose low-mercury fish. Vegetable rolls, shrimp tempura rolls, California rolls, and eel rolls are all solid options that give you the sushi experience without the risk.
If you’re making sushi at home, use the same rules. Cook all seafood to 145°F, avoid high-mercury species, and keep everything refrigerated until you eat it. Homemade rolls with cooked shrimp, crab, or vegetables give you full control over what goes in.