Poly- and perfluorinated alkyl substances (PFAS) are a group of chemicals that are widely used, prevalent in the environment, associated with several toxic effects, and often have long half-lives. Their persistence and relevant toxicity are the primary causes of environmental and human health concerns, and they are referred to as “forever chemicals” because of their persistence. Environmental accumulation caused by slow natural biodegradation and subsequent long environmental half-lives leads to bioaccumulation and makes PFAS more likely to be chronically toxic with potential transgenerational effects. Ultimately, it is this persistence that causes the greatest concern because PFAS-contaminated sites need costly remediation techniques, or else the contaminated areas will not be available for proper economic development because of social and economic suppression. Non-PFAS, alternative Aqueous Film Forming Foams (AFFF) that are considered environmentally friendly, are being heavily considered or currently used for fire suppression instead of PFAS-based products. The bioaccumulation and toxicity of alternative AFFF are just starting to be studied. The purpose of this review is to discuss the basic environmental and human health effects of PFAS and alternative AFFF that propel regulatory changes, increase clean-up costs, reduce economic development, and drive the development of novel alternatives.