Abstract: Tetrodotoxin (TTX) is easily enriched in pufferfish and snails, and TTX poisoning incidents often occurred in the coastal areas of China due to consumption of edible snails. Samples of snails and pufferfish were collected from the coastal waters of China and TTX was detected by liquid chromatography-tandem mass spectrometry. In 2018, TTX was frequently detected in Nassarius spp. in the coastal waters of Zhejiang and Jiangsu provinces, and the highest concentration of 5.35 mg/kg appeared in the snail Babylonia sp. in Ningde, Fujian province. The snail TTX pollution in China was mainly distributed in the coastal waters of Fujian, Zhejiang and Jiangsu provinces, and usually appeared in spring and summer. TTX in snail was occasionally detected in the coastal waters of Shandong province, and has not been detected in the coastal waters of Liaoning, Guangdong, Guangxi and Hainan provinces. High levels of TTX were found in pufferfish from the coastal waters of Tianjin and Liaoning province.