Between 2000 and 2009, there were 338 fugu related food poisonings nationwide. Out of that, there were 23 deaths. In Tokyo, there were seven deaths.
The BBC recently visited an experience fugu chef who has been preparing fugu for sixty years. To get his license, he had to train for two years and then take a notoriously difficult test.
To prepare fugu, all the fish's guts must be removed. According to The Japan Times, fugu liver, ovaries, and other internal organs have enough neurotoxins to be lethal. Ingesting it causes paralysis and then death.
It's not just the thrill. People enjoy the taste and shell out between ¥5,000 (US$62) and ¥30,000 ($375) for fugu meals.
The strict license is now somewhat outdated because many Tokyo restaurants buy fugu from other prefectures with more relaxed regulations. Starting this fall in Tokyo, it will be possible to serve fugu after going to a one-day class. This will mean that more inexpensive fugu will be served in Tokyo.
Other areas of Japan will continue to have their own fugu licenses.
While your chances of fugu food poisoning are extremely low, you might want to be dead certain that your chef is fugu experienced.
Check out the BBC video in the link below to see a fugu chef gut the poisonous parts of the fish. Note how the chef separates parts of the fish into two pans: one is marked "edible" and the other is marked "inedible".