Sustainable management of plant diseases is a perennial challenge for pome fruit and stone fruit producers in humid regions throughout the world. Delayed orchard profitability, decreased orchard longevity, reduction in fruit quality and unsalable fruit caused by fungal and bacterial diseases of tree fruit result in devastating economic losses annually. Globally, tree fruit growers are increasingly relying on an integrated management approach through the incorporation of predictive modelling and biological, chemical and cultural control methods to mitigate disease-associated losses. This chapter provides an introduction of tree fruit production and general management paradigms, followed by a discussion of main pre-harvest fungal and bacterial diseases, methods of integrated disease management and a discussion of advances in technology for pathogen detection and disease management. Finally, the chapter looks ahead to future challenges of the tree fruit industry and provides detailed guidance on further reading in this area.