The rapid growth of the aquaculture industry has led to increased demand for sustainable production to meet global seafood needs. However, the widespread use of antibiotics to control disease outbreaks in aquaculture has contributed to the rise of antibiotic-resistant bacteria, posing significant risks to both aquatic ecosystems and human health. As a result, there is a growing pressure on the industry to adopt alternatives to antibiotics that are both effective and environmentally friendly. Several strategies have emerged to address this challenge, including the use of natural antimicrobial agents, improved immune-boosting methods, and innovative disease-control technologies. These alternatives offer the potential to reduce reliance on antibiotics while maintaining the health and productivity of farmed species. Research into these approaches has shown promising results, highlighting their role in enhancing fish immunity, reducing pathogen loads, and improving overall production efficiency. With increasing consumer awareness and regulatory demands for safer, more sustainable aquaculture practices, developing and implementing these alternatives are critical to the industry’s future. This chapter discusses the above-mentioned potential alternatives for sustainable aquaculture.