Handfish (Family Brachionichthyidae) is the most threatened marine teleost fish family, however, there is little information on handfish health. We reviewed the results of submissions of mortalities from captive and captive bred spotted handfish (Branchionichthys hirsutus (Lacepède, 1804)) and red handfish (Thymichthys politus (Richardson, 1844)) from a public aquarium from January 2018 to February 2024. Seventeen cases for spotted handfish (comprising 33 individuals) and five cases for red handfish (one individual each) were submitted for mortality investigation. In 2018-2019, six of seven cases were diagnosed with scuticociliatosis. Other conditions included epitheliocystis (1 of 17), infections with metazoan parasites (2 of 17 for spotted handfish and 2 of 5 for red handfish) and hepatic lipidosis (4 of 17). Most submissions were fixed samples for histology with only one fish suitable for microbiology. We recommend development of a coordinated health program for all captive breeders and aquaria, which should include sampling protocols, collection, and preservation in a range of fixatives of all the dying or dead handfish and adapting sublethal sampling, including tank water to assess presence of pathogens and other microorganisms. Risk factors for handfish health in captivity should be assessed. Handfish health database should be established to avoid loss of corporate knowledge in this area.