Metal additive manufacturing (AM), also known as metal three-dimensional (3D) printing, is a new technology offering design freedom to create complex structures that has found increasing applications in industrial processes. However, due to the fine metal powders and high temperatures involved, the printing process is likely to generate particulate matter (PM) that has a detrimental impact on the environment and human health. Therefore, comprehensive assessement of the exposure and health hazards of PM pollution related to this technique is urgently required. This review provides general knowledge of metal AM and its possible particle release. The health issues of metal PM are described considering the exposure routes, adverse human health outcomes and influencing factors. Methods of evaluating PM exposure and risk assessment techniques are also summarized. Lastly, future research needs are suggested. The information and knowledge presented in this review will contribute to the understanding, assessment, and control of possible risks in metal AM and benefit the wider metal 3D printing community, which includes machine operators, consumers, R&D scientists, and policymakers.