Management of apple pests is a necessary and challenging part of crop production. Cosmetic and phytosanitary standards entail management of key pests to very low levels which are biologically difficult to sustain. This chapter begins by covering key pests. Such pests drive integrated pest management (IPM) systems, and although few in number, they shape the entire system. We then consider indirect pests, which may be tolerated in moderate densities, and are therefore more amenable to other control tactics, especially biological control. We argue that IPM tactics which control key pests without disrupting biological control of secondary pests are therefore essential for a more stable and sustainable apple IPM. After considering the tools and tactics available as part of a sustainable IPM program, we turn to the challenges facing IPM, such as pesticide resistance and invasive species, which require innovative solutions for future IPM systems.