In the first review of potentially toxic elements (PTEs) in fish in water ecosystems in Serbia, 40 studies related to fish contamination with PTEs were identified and evaluated. Studies of concentrations of PTEs in fish tissues covered 28 ecosystems (108 localities). The main studied river ecosystems were the Danube and the Sava, and the Međuvršje reservoir was the most studied standing water ecosystem. Among the most studied fish species were catfish (Silurus glanis), followed by pikeperch (Sander lucioperca), bream (Abramis brama), carp (Cyprinus carpio), and barbel (Barbus barbus). There were 48 “hot spot” sampling sites where concentrations of Hg, Cd, Pb, As, Ni, Fe, and/or Cu exceeded the maximum permitted concentrations (MPCs) prescribed by legislation. Elevated concentrations of these elements were the most detected in fish species sampled in the Danube, Sava, and rivers belonging to the Velika Morava basin. Hg concentrations were the most common above MPC in muscle tissue of species sampled from the Danube and Sava rivers. On the other hand, we can single out the species Vimba bream (Vimba vimba), sampled in Danube River in Zemun near Belgrade, as the safest species for human consumption due to the largest number of elements in fish meat below detection limits. Finally, having in mind all the criteria prescribed by U.S. EPA (2000), we identify and recommend two predatory fish species pikeperch (S. lucioperca) and catfish (S. glanis), and bottom-feeding fish species barbel (B. barbus) as bioindicators of PTEs contamination in Serbian waters.