This systematic review examines off-flavors in farmed freshwater fish, which compromise sensory quality and consumer acceptance, resulting in financial losses. Using the PRISMA method, 7,576 documents from the Scopus and Web of Science databases were analyzed, resulting in the selection of 44 studies published within the last six years. The articles were examined for their objectives, studied species, farming systems, main findings, gaps, and suggestions for future research. The studies highlight the influence of water quality, climatic conditions, management practices, and feeding, with an emphasis on the presence of cyanobacteria, algal blooms, fungi, and metabolic compounds, particularly geosmin and 2-methylisoborneol, which are the main contributors to unpleasant tastes and odors. The review highlights the need to enhance management practices and control of these compounds, while also suggesting new research to develop more effective and accessible mitigation methods. The importance of continuous water quality monitoring is emphasized as an essential strategy to prevent the formation of off-flavors. In summary, the review provides a comprehensive overview of undesirable tastes and odors in freshwater fish, identifies knowledge gaps, and proposes directions for future investigations, which are crucial for the sustainability and quality of aquaculture production.