Shrimp aquaculture, particularly in South and Southeast Asia, substantially contributes to economic growth and food security. However, the sectors’ heavily reliance on antibiotics together with weak biosecurity – driving the rise of antimicrobial resistance (AMR). This review synthesizes evidence from 2000 to 2025 on antibiotic use, resistance pathways, and the associated environmental (particularly mangrove habitats) and public-health risks. Through the integration of antibiotic management, diagnostic development, and the control of non-antibiotic diseases on the broad One Health platform, this review emphasizes the interdependence of shrimp aquaculture, ecosystem health, and public health. The historical shift from traditional, mangrove-linked practices to intensive, export-oriented systems accelerated the loss of mangroves and increased ecological vulnerability. High disease pressure in intensive farms drove routine, sometimes inappropriate antibiotic use (mostly oxytetracycline, florfenicol, and sufonamides), and the emergence of resistance. Weak regulation and limited diagnostics, along with widespread use of non-approved drugs, enabled persistent selection pressures across production environments, further shaping AMR development. Diverse AMR genes (such tetA, sul1, and blaCTX-M) occur in farm-associated bacteria, raising concerns about movement through aquatic ecosystems and human exposure. Effluents from shrimp farms carry antibiotic residues and resistant microbes into nearby mangroves, where resistance genes persist, spread, and disrupt ecological functions. These pressures diminish shrimp health and productivity, alter microbial nitrogen cycling, suppress diazotrophic taxa, and reduce nitrogenase and functional gene activity compromising mangrove ecosystem services like nutrient cycling, biodiversity, and coastal protection. Public-health risks arise when food chain entry or occupational exposure occurs via either residues or resistant bacteria; these necessitate strong farm-level controls, surveillance, and hygiene practices. AMR mitigation needs tighter antibiotic governance, expanded diagnostic capacity, and wider adoption of non-antibiotic disease-management strategies within a coordinated One Health framework. Future progress depends upon closing knowledge gaps, improving monitoring, and aligning regulations and farm practice for long-term environmental and public-health protection.