The global growth of farmed shellfish production has resulted in considerable research investigating how biofouling compromises farm productivity. Shellfish fitness can be compared between fouled stock and stock which has undergone treatment. As treatment options are often harsh, they may deleteriously affect stock. The projected impact of biofouling may therefore be confounded by the impact of treatments. Given the substantial cost of fouling removal, some have questioned the necessity of biofouling mitigation strategies. Meta-analysis revealed that biofouling typically reduces shellfish fitness. However, the fitness of treated stock was often lower or equal to fouled control stock, indicating that many common antifouling (AF) strategies are ineffective at enhancing farm productivity. Overall, caution and diligence are required to successfully implement biofouling mitigation strategies. The need remains for increased passive prevention approaches and novel AF strategies suitable for shellfish culture, such as strategic siting of bivalve farms in areas of low biofouling larval supply.