Aflatoxins are a class of carcinogenic mycotoxins produced by Aspergillus fungi and are known to contaminate a large portion of the world's food supply. Aflatoxin B1 (AFB1) is the most potent of these compounds and has been well-characterized to lead to the development of hepatocellular carcinoma (HCC) in humans and animals. This review focuses on the metabolism of AFB1, including epoxidation and DNA adduction, as it concerns the initiation of cancer and the underlying mechanisms. The link between AFB1 consumption and HCC is also discussed including synergistic interactions with the hepatitis B virus. Toxic effects of AFB1, including growth suppression, malnutrition, and immunomodulation, are also covered. This review also describes recent reports of AFB1 occurrence in global food supplies and exposures in occupational settings. Furthermore, a summary of recent detoxification methods is included to indicate the present state of the field in developing aflatoxin control methods. This information shows that AFB1 occurs frequently in food supplies at high concentrations, particularly in maize. Regarding detoxification methods, chemical control methods were the fastest methods that still retained high detoxification efficacy. The information presented here highlights the need to implement new and/or existing detoxification methods to reduce the global burden of AFB1 toxicity. •AFB1 is a potent hepatocarcinogen that contaminates a large portion of the world’s food supply.•After ingestion, AFB1 forms DNA adducts which initiates carcinogenesis and can work synergistically with hepatitis B virus.•AFB1 is also strongly linked with many other toxicities including growth impairment, malnutrition, and immunomodulation.•Diverse chemical and biological control methods have been studied to reduce AFB1 levels in food.