Bivalves have been grown and transported for culture for hundreds of years and the introduction of some species outside of their native range for aquaculture has been suggested to be one of the greatest modes of introduction of exotic marine species. However, there has yet to be a thorough assessment of the importance of aquaculture and bivalve culture in particular, to the introduction and spread of exotic species. This paper reviews some of the environmental and ecological implications of the relationship between bivalve aquaculture and the introduction and spread of exotic species, management implications and mitigation strategies. Two broad classes of introductions of exotic species may result from activities associated with bivalve aquaculture. First, the intentional introduction of exotic species into an area for aquaculture purposes, i.e. the “target” species. These are typically foundation or engineering species and may have a considerable influence on receiving ecosystems. Second, the introduction of species that are either associated with introduced bivalves or facilitated by aquaculture activities (i.e. structures or husbandry practices). These may include both “hitchhiking” species (organisms that grow in association with or may be transferred with cultured bivalves) and disease causing organisms. Management options should include the use of risk assessments prior to transfers and quarantines. Various types of mitigation for exotic species have been evaluated but are generally not very successful. Because the risk of exotic species to ecosystems and the bivalve farming industry itself may be great, effort should be directed to better predict and halt introductions of potentially harmful species.