Organic greenhouse horticulture has expanded considerably during the last decades to meet consumer demand. Organic greenhouse cultivation constitutes a sustainable alternative to mitigate producer challenges related to new pest infestation, weed infestation, extreme temperature events, drought, frequent episodes of hail as well as strong rain and wind, and soil erosion. This chapter highlights the current regulation and situation of organic greenhouse cultivation in the world, presents yield gap and profitability compared with conventional farming and describes recent advances related to robust plant material, soil and soilless growing systems, soil health, biostimulants, fertilisation and water management, plant protection and quality value of organic products. Finally, the chapter considers the environmental impact of organic greenhouse cultivation and future trends in this area, providing detailed guidance on further reading.