Antibiotic use in food animals is a major contributor to the global public health crisis of antibiotic resistance. While most antibiotic use occurs in agricultural settings, the role of antibiotic use in farm animals in the development of resistance and its impact on human health has not been adequately studied. This review summarizes the literature on the role of antibiotics in the development of resistance and its risk to human health, and examines existing regulatory and policy documents. It also proposes strategies to address current gaps in knowledge. Antibiotic resistance is a growing public health threat, with community-associated resistant strains now implicated in many hospital-acquired infections. Resistance arises through natural selection, with mutations in bacteria making them resistant to antibiotics. The use of antibiotics in food animals can lead to the spread of resistant bacteria, which can enter the food supply and be widely disseminated in food products. Commensal bacteria in livestock can serve as reservoirs for resistant genes that can be transferred to pathogenic organisms in humans. The use of antibiotics in food animals is widespread, yet poorly characterized. Existing studies have not well characterized the risks to human health or the benefits to animal production. There is a lack of consistency in national and international policies regarding antibiotic use in food animals. The review highlights the different applications of antibiotics in food animals, including therapeutic, prophylactic, and subtherapeutic use. It also discusses the potential for antibiotic resistance to spread through the environment, food products, and human populations. The review also examines the epidemiologic evidence linking antibiotic use in food animals to antibiotic resistance in humans. It highlights the need for a comprehensive risk assessment framework to understand the problem. The review also discusses key national and international policies on the use of antibiotics in food animals and proposes future directions for research and monitoring of agricultural antibiotic use. The review concludes that antibiotic use in food animals is a major contributor to the development of resistant organisms that cause life-threatening human infections. It emphasizes the need for increased research, funding, and policy action to address the growing public health crisis of antibiotic resistance. The review also highlights the importance of developing a scientific agenda to guide research on antimicrobial use in food animals and to fund agricultural research that reflects the priorities identified by the research agenda. It also calls for urgent action to address barriers to the collection and analysis of antimicrobial use data.Antibiotic use in food animals is a major contributor to the global public health crisis of antibiotic resistance. While most antibiotic use occurs in agricultural settings, the role of antibiotic use in farm animals in the development of resistance and its impact on human health has not been adequately studied. This review summarizes the literature on the role of antibiotics in the development of resistance and its risk to human health, and examines existing regulatory and policy documents. It also proposes strategies to address current gaps in knowledge. Antibiotic resistance is a growing public health threat, with community-associated resistant strains now implicated in many hospital-acquired infections. Resistance arises through natural selection, with mutations in bacteria making them resistant to antibiotics. The use of antibiotics in food animals can lead to the spread of resistant bacteria, which can enter the food supply and be widely disseminated in food products. Commensal bacteria in livestock can serve as reservoirs for resistant genes that can be transferred to pathogenic organisms in humans. The use of antibiotics in food animals is widespread, yet poorly characterized. Existing studies have not well characterized the risks to human health or the benefits to animal production. There is a lack of consistency in national and international policies regarding antibiotic use in food animals. The review highlights the different applications of antibiotics in food animals, including therapeutic, prophylactic, and subtherapeutic use. It also discusses the potential for antibiotic resistance to spread through the environment, food products, and human populations. The review also examines the epidemiologic evidence linking antibiotic use in food animals to antibiotic resistance in humans. It highlights the need for a comprehensive risk assessment framework to understand the problem. The review also discusses key national and international policies on the use of antibiotics in food animals and proposes future directions for research and monitoring of agricultural antibiotic use. The review concludes that antibiotic use in food animals is a major contributor to the development of resistant organisms that cause life-threatening human infections. It emphasizes the need for increased research, funding, and policy action to address the growing public health crisis of antibiotic resistance. The review also highlights the importance of developing a scientific agenda to guide research on antimicrobial use in food animals and to fund agricultural research that reflects the priorities identified by the research agenda. It also calls for urgent action to address barriers to the collection and analysis of antimicrobial use data.