Excessive vigor of European pear varieties and a dearth of dwarfing rootstocks create significant challenges to the establishment and management of modern high-density orchards. The pronounced negative relationship between pear tree vigor and precocity requires considerable intensive horticultural intervention to expedite a return on investment and to achieve maximum yield potential. Plantings of low-to-moderate tree densities are no longer economically sustainable given their characteristically inconsistent fruit quality and suboptimal yields. Nascent technologies and novel horticultural strategies have potential to balance reproductive and vegetative development of pear trees and facilitate the cultural management of high-density orchards. This chapter presents the challenges and opportunities in pear cultivation. A review of pear floral biology and fruit setting habits and their complex interaction with environmental factors is presented along with practical horticultural strategies to promote balanced canopies. The physiological bases for applying these strategies and their implications on agronomic processes and whole plant performance are highlighted.