Fusarium crown rot (FCR) of wheat (Triticum aestivum L.), primarily caused by fungal pathogens such as Fusarium pseudograminearum, poses a serious threat to wheat production and grain quality due to the synthesis of mycotoxins including deoxynivalenol (DON). In recent years, the incidence and severity of FCR have kept growing in the northern wheat-growing regions of China. This review summarizes the epidemiological characteristics of FCR, elucidates the pathogenic mechanisms of the pathogen and host resistance responses, and proposes an integrated management strategy combining resistant cultivar breeding with monitoring and early warning systems. Such integrated approaches can effectively reduce yield losses and toxin contamination, promoting sustainable wheat production. Future efforts should focus on investigating the interaction mechanisms between the pathogen and wheat plants, developing broad-spectrum resistant cultivars, designing green and efficient control products, and establishing a technical system of early prevention-pathogen monitoring-post-infection management to ensure safe wheat production and enhance food security.