Mycotoxins, the toxic compounds produced by mold secondary metabolism, represent a relevant source of danger to humans through alimentary channels. Efforts have been made by researchers and by national authorities to assess mycotoxin incidence in food, but often results are to be considered approximate or inaccurate due to the huge difficulties posed by sampling procedures. More recently the evaluation of mycotoxins in biological fluids have been given increasing attention since the results may offer valuable indications, although general on the overall status of mycotoxin contamination in food and feed. The assessment of the degree of exposure to these contaminants in the population or in specific groups can also be pursued. Researches on mycotoxins in biological fluids greatly contribute to clarify the mechanism of health impairment attributable to these toxic compounds and to elucidate the dose-response relationship. Despite the considerable efforts devoted to mycotoxin research in the past few decades, improvements in methodology has to be achieved mainly in sampling procedures and in quality assurance of the laboratories involved in mycotoxin analysis, as well as in the selection of appropriate biomarkers.