Traditional food markets (TFMs) are dynamic and complex systems that play a vital role in societies across the globe. They provide fresh, affordable food, help preserve cultural traditions, and support the livelihoods of millions. However, these markets also present inherent risks associated with the trade of live animals and animal-derived products, including the emergence and spread of zoonotic diseases, which are underreported in these settings. This review explores the dual role of TFMs as essential societal hubs and hotspots for zoonotic diseases, emphasizing the need for surveillance and targeted One Health research on pathogens in these environments. By assessing the health risks associated with the presence of specific animals and their pathogens in TFMs, this review lays the foundation for developing the evidence-based risk assessments and mitigation strategies needed to reduce zoonotic disease risk. Enhancing the safety and sustainability of TFMs through integrated One Health approaches will be crucial for balancing the cultural and economic importance of TFMs with the need for increased global health security.