Abstract This review examines the use of insect meal (IM) as a substitute for fishmeal (FM) in fish feeds within the past decade. While global interest in this alternative is growing, research on its effects on fish digestibility, blood parameters, and economic performance has been limited. Meta-analysis on the apparent digestibility coefficient revealed a negative effect summary on dry matter (−0.92) and crude lipid (−0.51), although the difference between the two groups was relatively minor. However, a positive effect summary was reported in the apparent digestibility of crude protein (0.12), suggesting a potential advantage in the utilization of protein by fish fed with IM-containing diets. Whereas meta-analysis on fish blood parameters demonstrates varying effects summary, necessitating further research. Analysis of economic performance revealed an overall better economic performance in the IM diet with an effect summary of −0.08 for feed cost and 0.00 for the economic profit index. Overall use of IM in aquafeed shows promise in improving feed quality and fish performance, potentially becoming a sustainable alternative to traditional FM. Recommendations include exploring IM’s impact on fish blood parameters through more investigations. Shifting focus from traditional measures to markers directly linked with fish health and immune response can provide more precise insights. Moreover, exploring various components of IM, such as lipids and functional elements like chitin, through simplified breakdown methods, can significantly enhance our comprehension of their nutritional value. Analyzing how each part influences fish health could pave the way for a sustainable and efficient alternative to FM in aquaculture.