Cylindrospermopsin (CYN) is rapidly being recognised as one of the most globally important of the freshwater algal toxins. The ever-expanding distribution of CYN producers into temperate zones is heightening concern that this toxin will represent serious human, as well as environmental, health risks across many countries. Since 1999, a number of studies have demonstrated the ability for CYN to bioaccumulate in freshwater organisms. This paper synthesizes the most current information on CYN accumulation, including notes on the global distribution of CYN producers, and a précis of CYN’secological and human effects. Studies on the bioaccumulation of CYN are systematically reviewed, together with an analysis of patterns of accumulation. A discussion on the factors influencing bioaccumulation rates and potential is also provided, along with notes on detection, monitoring and risk assessments. Finally, key gaps in the existing research are identified for future study.