Bananas were among the first crops cultivated by man and continue to be important for the livelihoods of millions of people throughout the tropics and subtropics. Yet many cultivars and landraces are susceptible to biotic and abiotic stresses. Genetic resistance to diseases and pests is the best form of crop protection and it is imperative to develop new cultivars that perform well across a variety of changing environments. Currently, the production of improved cultivars with relevant gains in resistance to diseases and pests and other preferred agronomic traits has been accomplished through both conventional and non-conventional breeding. This chapter reviews the various genetic improvement strategies used to develop new banana cultivars and discusses the strategies that have been employed over the last one hundred years. They include hybridization approaches, mutation breeding, genetic transformation and marker assisted selection. The role of genomics and more recent molecular breeding approaches are also discussed.