Regular inspection of fruit crops for diseases is a vital part of integrated disease management. Combining this information with that generated from disease warning systems can play a significant role in achieving perfect fruit with minimal use of fungicides. This chapter includes general discussions on fruit disease monitoring, disease warning systems and decision making; it then uses examples of specific diseases in apple and pear to illustrate the role of both orchard monitoring and disease warning systems in integrated disease management. The following diseases are covered: apple scab, apple powdery mildew, European apple canker, sooty blotch, fly speck, fire blight and storage rots. The examples given demonstrate how in current ‘best practice’ orchard monitoring and, where appropriate, disease warning systems can be integrated to make decisions on treatment to control the diseases to produce quality fruit with minimum input of fungicides. The use of future technologies such as smart spore traps, drones and orchard scanners are also discussed.