The western corn rootworm, Diabrotica virgifera virgifera LeConte, is among the most serious pests of maize in the United States. Since 2003, transgenic maize that produces insecticidal toxins from the bacterium Bacillus thuringiensis (Bt) has been used to manage western corn rootworm by killing rootworm larvae, which feed on maize roots. In 2009, the first cases of field-evolved resistance to Bt maize were documented. These cases occurred in Iowa and involved maize that produced Bt toxin Cry3Bb1. Since then, resistance has expanded to include other geographies and additional Bt toxins, with some rootworm populations displaying resistance to all commercially available Bt traits. Factors that contributed to field-evolved resistance likely included non-recessive inheritance of resistance, minimal fitness costs of resistance and limited adult dispersal. Additionally, because maize is the primary agricultural crop on which rootworm larvae can survive, continuous maize cultivation, in particular continuous cultivation of Bt maize, appears to be another key factor facilitating resistance evolution. More diversified management of rootworm larvae, including rotating fields out of maize production and using soil-applied insecticide with non-Bt maize, in addition to planting refuges of non-Bt maize, should help to delay the evolution of resistance to current and future transgenic traits.