The absence of much literature on the Patagonian fish fauna in comparison with that of the neotropics, has previously been blamed on its poor species diversity. Knowledge of the fishes of Patagonia, however, rose sharply at the beginning of the present century, allowing for an understanding of the complex biogeographical history that has led to the present diversity and distribution patterns. There are several new and potential threats to biodiversity and conservation of Patagonian fishes, such as the introduction of exotic species, damming, climate change and changes geared to safeguard economic interests, often acting synergistically. A great amount of new information is now available and the aim of the present review is to articulate this knowledge in a comprehensive way in order to aid in the development of tools to face the increasing challenges posed by environmental change and human activity. Knowledge about fishes of Patagonia has grown at the same time as human actions, and presence.