The ongoing shift from traditional diets to plant-based meat alternatives is governed by the friendly-character related to consumers' health and environment. However, the beneficial aspects of meat alternatives overshadow the possible adverse effects that accompany them. The present systematic review shows that the contamination of the most common plant-based meat alternatives, soybean, chickpea, pea, and seitan with mycotoxins is understudied or not studied at all. Even though they are toxic and were found in soy-based food, tropane and β-carboline alkaloids contamination data in plant-based meat alternatives is also lacking. Mycotoxin mixtures that can have additive or synergistic toxic effects have been found in multiple soy-based food, revealing the high risk that consumers expose themselves to. To better understand the risks that come along with the shift to plant-based meat diets, future research is needed regarding contamination data of plant-based meat alternatives with natural toxins. Maximum limits for contaminants found in plant-based meat alternatives need to be established by the European Commission in order to ensure consumers' food safety.