Is sushi safe during pregnancy?

The verdict

Sushi is safe during pregnancy if the fish is cooked. Sushi made with raw fish is not recommended by any national health authority.

Safe: California rolls (cooked crab or crab stick), cooked prawn nigiri, unagi and anago (grilled eel), tamago (egg), cooked salmon, tuna mayo made with cooked or canned tuna, avocado maki, cucumber maki, inari and most vegetable rolls.

Not recommended: sashimi, raw salmon or tuna nigiri, raw scallop, sea urchin, raw prawn (ama ebi), and rolls containing raw fish. Smoked salmon in sushi is also on the avoid list - it is cured, not cooked.

Why raw fish, specifically

There are two separate hazards, and only one of them is solved by freezing.

Parasites. Anisakis and related worms infect finfish and squid. Eating live larvae can cause abdominal pain, nausea and allergic reactions. UK law addresses this at the business end: food businesses placing fishery products intended to be eaten raw on the market must freeze them to at least minus 20C for 24 hours or minus 35C for 15 hours. Cooking to 60C for a minute does the same job. This is why the older advice - sushi is fine if the fish has been frozen - existed at all, and it was correct about parasites.

Listeria. Freezing does not kill Listeria monocytogenes. It survives freezing and grows at refrigerator temperatures. This is the hazard that the frozen-fish exemption never addressed, and it is now the reason UK advice has changed. Listeriosis is usually mild in the mother but can cause miscarriage or stillbirth, or serious illness in a newborn.

Cooking handles both. Freezing handles one.

The UK reversed its position

This is worth stating plainly because a large amount of published UK advice is now out of date, including on otherwise reputable sites.

Until around 2023 the NHS listed raw or lightly cooked fish in sushi as something you could eat if the fish had been frozen first. The current NHS foods-to-avoid page, last reviewed 15 June 2026, lists on the avoid side: sushi made with raw fish (even if it has been previously frozen) or raw shellfish. The parenthesis is deliberate - it is an explicit withdrawal of the old exemption. The stated mechanism is listeria, not parasites.

The freezing requirement still exists in UK law, but it is a rule for fish businesses about parasite control. It was never a pregnancy safety guarantee, and the NHS no longer presents it as one.

There is also a wrinkle worth knowing if you are relying on the freezing rule at all: UK guidance grants a general freezing exemption for farmed Atlantic salmon, halibut and rainbow trout, because farming methods carry minimal parasite risk. Raw farmed salmon in a UK sushi restaurant may legally never have been frozen.

What about the rice, and restaurant sushi generally

Sushi rice is acidified with vinegar, which is a food-safety measure in its own right, and cooked rolls do not become unsafe by sitting next to raw ones. The relevant question is what is in the roll.

Pre-packed supermarket sushi introduces a second consideration. The NHS lists pre-packaged sandwiches and salads as foods to keep chilled and eat before the use-by date, because ready-to-eat chilled foods can carry listeria. The same logic applies to a chilled sushi box: buy it cold, eat it the same day, and choose cooked fillings.

If you have already eaten raw fish sushi

The absolute risk from a single meal is low. The CDC estimates about 1 in 25,000 pregnancies a year are affected by listeria from all sources combined, so one sitting is a small fraction of an already small number. There is no preventive test and nothing to take.

What to do is watch for symptoms, and know that the window is long. ACOG notes listeriosis symptoms can appear as late as two months after eating contaminated food. Fever, chills, muscle aches, diarrhoea or an upset stomach are the ones that matter. If you develop a fever, contact your midwife or doctor and tell them what you ate and when. Listeriosis is treated with antibiotics, and treating the mother is what protects the pregnancy.

Parasite illness, by contrast, announces itself quickly - severe abdominal pain and vomiting within hours to a couple of days. That also warrants a call, but it is not a pregnancy-specific emergency.

Where guidance differs

On this topic, it now mostly does not - which is itself the news, because it did until recently.

The NHS, ACOG, the CDC, FSANZ, Health Canada and New Zealand Food Safety all advise against raw fish in pregnancy. ACOG is explicit that cooked sushi is safe: do not eat sushi made with raw fish (cooked sushi is safe). The CDC lists sashimi, sushi and ceviche together as riskier choices. Health Canada names raw seafood, such as sushi, with seafood cooked to 74C as the safer alternative. FSANZ groups oysters, sushi, sashimi and ceviche as chilled ready-to-eat or raw seafood to avoid, alongside smoked seafood and chilled cooked prawns. New Zealand's MPI includes pre-prepared cold foods such as sushi in its eating-out avoid list.

The one residual difference is emphasis on smoked fish. UK guidance treats cold-smoked and cured fish - smoked salmon, gravlax - as a distinct listeria hazard following a UK outbreak with 24 linked cases since 2020 and four deaths, and the FSA advises higher-risk consumers to avoid it or cook it until steaming hot. The NHS lists it under foods to be careful with, to be cooked until steaming. US and Canadian guidance also flags refrigerated smoked seafood, but without the outbreak-specific framing. Australia includes smoked seafood in its general higher-risk list.