Maize underpins food security in South Africa. An annual production of more than 10 million tons is a combination of the output of large-scale commercial farms plus an estimated 250 000 ha cultivated by smallholder farmers. Maize leaves are a rich source of nutrients for fungal pathogens. Farmers must limit leaf blighting by fungi to prevent sugars captured by photosynthesis being ‘stolen’ instead of filling the grain. This study aimed to fill the knowledge gap on the prevalence and impact of fungal foliar diseases in local smallholder maize fields. A survey with 1124 plant observations from diverse maize hybrids was conducted over three seasons from 2015 to 2017 in five farming communities in KwaZulu-Natal Province (Hlanganani, Ntabamhlophe, KwaNxamalala) and Eastern Cape Province (Bizana, Tabankulu). Northern leaf blight (NLB), common rust, Phaeosphaeria leaf spot, and grey leaf spot had overall disease incidences of 75%, 77%, 68% and 56%, respectively, indicating high disease pressure in smallholder farming environments. NLB had the highest disease severity (LSD test, p<0.05). A yield trial focused on NLB in KwaZulu-Natal showed that this disease reduced yields in the three most susceptible maize hybrids by 36%, 71% and 72%, respectively. Eighteen other hybrids in this trial did not show significant yield reductions due to NLB, which illustrates the progress made by local maize breeders in disease resistance breeding. This work highlights the risk to smallholder farmers of planting disease-susceptible varieties, and makes recommendations on how to exploit the advances of hybrid maize disease resistance breeding to develop farmer-preferred varieties for smallholder production.