A method for the determination of methylmercury in plasma and serum samples was developed. The method uses isotope dilution with 198Hg-labelled methylmercury, extraction into dichloromethane, back-extraction into water, aqueous-phase ethylation, purge and trap collection, thermal desorption, separation by gas chromatography, and mercury isotope specific detection by inductively coupled plasma mass spectrometry. By spiking 2 mL sample with 1.2 ng tracer, measurements in a concentration interval of (0.007–2.9) μg L−1 could be performed with uncertainty amplification factors <2. A limit of quantification of 0.03 μg L−1 was estimated at 10 times the standard deviation of concentrations measured in preparation blanks. Within- and between-run relative standard deviations were <10% at added concentration levels of 0.14 μg L−1, 0.35 μg L−1 and 2.8 μg L−1, with recoveries in the range 82% to 110%. Application of the method to 50 plasma/serum samples yielded a median (mean; range) concentration of methylmercury of 0.081 (0.091; <0.03–0.19) μg L−1. This is the first time methylmercury has been directly measured in this kind of specimen, and is therefore the first estimate of a reference range.