Musa spp. (banana and plantain) is the most widely consumed and exported fruit globally, and it plays a crucial role in the diets of billions of people worldwide. Over the years, many diseases have threatened this crop, including the recent emergence of Fusarium wilt, caused by Fusarium oxysporum race 4. Puerto Rico is home to numerous economically significant variants of Musa spp. Due to the crop's importance in the island's economy and nutrition, research on maintaining existing varieties and developing new ones has been initiated. Although Fusarium oxysporum f.sp. cubense race 4 has not been detected in Puerto Rico, it has been detected in the Caribbean region. Therefore, it is essential to know both the plant and the pathogen to prevent and fight this disease. This review summarizes information about Musa spp, including its plant description, morphology, and genetic characteristics. Furthermore, it covers information about Fusarium sp., its pathogenicity, detection methods, and prevention of its spread. We also reviewed the few articles published for the island of Puerto Rico about Musa and Fusarium, and the guidelines suggested regarding the threat of the Fusarium wilt race 4 for the island. Finally, we underline Puerto Rico's opportunities to develop disease-resistant Musa cultivars.