Ocean acidification, driven by the absorption of anthropogenic carbon dioxide into seawater, poses a significant threat to marine environments and biodiversity. This comprehensive review examines the specific impacts of acidification on the reproductive physiology of fish, integrating recent advances in our understanding of gonadal development, gametogenesis, and early embryonic development. We synthesize current findings on how altered carbonate chemistry disturbs the reproductive system from gametogenesis and fertilization to larval development and beyond. Our analysis reveals that ocean acidification affects multiple physiological pathways, including disruption of the hypothalamic-pituitary-gonadal (HPG) axis, impairment of calcium signaling, and alterations in sex hormone synthesis. We propose a mechanistic model in which pH reduction may weaken Dax1-mediated repression of P450arom transcription, thereby dysregulating aromatase activity and leading to sex hormone imbalance that impairs gonadal development; however, this proposed mechanism requires direct experimental validation under ocean acidification, as the net outcome may be modulated by additional regulatory layers such as epigenetic modifications and other transcription factors. Furthermore, we discuss the synergistic effects of ocean acidification with temperature elevation and other stressors, which often exacerbate reproductive dysfunction. This review concludes that no multi-generational study has yet evaluated HPG axis disruption to population-level recruitment failure, a critical gap for fishery resource assessment. We emphasize the critical importance of multi-generational and field-based studies to fully understand these impacts, which is essential for forecasting consequences for global marine biodiversity and the long-term sustainability of fisheries.