Humans have fished sea cucumbers for thousands of years, using them primarily as a food source and as an ingredient in traditional medicines taken for a wide range of ailments. The vast majority of consumption as cuisine and medicine, the center of trade, and the drivers of exploitation remain in the People's Republic of China, Hong Kong SAR, and Taiwan PC. This chapter reviews the wide variety of human uses of sea cucumber products and its extraordinary trade history, and also attempts to provide insight into the changing state of sea cucumber exploitation globally. Culinary historical mention of consumption of sea cucumber and of its value as a health food item reaches as far back as the fourth century AD and The Canon of Gastronomy a Chinese Encyclopedia of edible and beneficial foods and "tonics".