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Banana (Musa spp.) is one of the most important fruit crops globally, serving as a staple food and key income source for millions across tropical and subtropical regions. However, its production is severely threatened by Fusarium wilt, or Panama disease, caused by the soil-borne fungus Fusarium oxysporum f. sp. cubense (Foc). This destructive pathogen infects the plant through roots, blocking vascular tissues and causing leaf yellowing, wilting, and plant death. Among the pathogen’s races, Tropical Race 4 (TR4) is especially devastating, affecting even the commonly grown Cavendish varieties. Managing Fusarium wilt is challenging due to the pathogen’s persistence in soil, its resistance to chemical controls, and the limited availability of resistant banana cultivars. Various strategies have been explored, including cultural practices, biological control, chemical treatments, botanical extracts, and breeding for resistant varieties. However, no single method provides complete control. Therefore, Integrated Disease Management (IDM), which combines multiple strategies, is emphasized as the most effective and sustainable approach. This article reviews the pathogen’s biology, symptoms, and current management practices, highlighting the need for integrated and region-specific solutions to ensure banana crop sustainability and food security.