Research into the development of pre-storage heat treatments is continuing for both disinfection (postharvest decay) and disinfestation (insect control) outcomes. This is driven by loss in availability or efficacy of postharvest fungicides, or treatments for insects such as methyl bromide. This chapter summarizes the range of methods of heat treatments, current research, the mode-of-action based on the product, pest and pathogen responses, and information on commercial use of heat treatments. The main commercial uses are hot air treatments of tropical fruit for fruit fly control, and control of decay by hot water treatments for citrus, organic apples, and tropical crops. There is increasing use of short duration treatments (e.g. hot water brushing or dips) for decay control and a broad range of heat treatments for bulb crops have been commercialized in the Netherlands. Cost of treatment is a key limitation, and technical innovations would improve commercial uptake.