Fusarium basal rot (FBR) is a soil-borne disease that affects Allium species worldwide. Although FBR has long been recognized as a major constraint to the production of economically important Allium species, information that could support disease management remains scattered. In this review, the current knowledge on the causal agents, symptomology and epidemiology, impact, and management strategies of FBR is synthesized. We highlight that FPR is associated with different complexes of several Fusarium species, of which Fusarium oxysporum and F. proliferatum are the most prevalent. These pathogenic complexes vary in composition and virulence, depending on sites and hosts, which can be challenging for disease management. Research to improve disease management using chemical pesticides, resistance cultivars, biocontrol agents, and cultural practices has achieved both promising results and limitations. Finally, research needs and future directions are proposed for the development of effective FBR management strategies.