Okadaic acid (OA) group toxins, including OA and its analogs, such as dinophysis toxins (DTXs), have been reported to cause diarrheal shellfish poisoning (DSP). These toxins are primarily produced by dinoflagellates and are accumulated in bivalves. Recently, the presence of Dinophysis sp., a causative alga of DSP, has been reported along the coasts of Korea, posing a potential risk of contamination to domestic seafood and exerting an impact on both the production and consumption of marine products. Accordingly, the European Food Safety Authority (EFSA) and the World Health Organization (WHO) have established standards for the permissible levels of OA group toxins in marine products for safety management. Additionally, in line with international initiatives, the domestic inclusion and regulation of DTX2 among the substances falling under the purview of management outlined by the 2022 diarrheal shellfish toxin standard have been implemented. In this study, we reviewed the physicochemical properties of OA group toxins, their various exposure routes (such as acute toxicity, genotoxicity, reproductive and developmental toxicity), and the relative toxicity factors associated with these toxins. We also performed a comparative assessment of the methods employed for toxin analysis across different countries. Furthermore, we aimed to conduct a broad review of human exposure cases and assess the international guideline for risk management of OA group toxins.