For many years, Fusarium species have been known as one of the most common pathogens, causing disease and producing mycotoxins in many host species both on-field and postharvest. Tomato is among the most relevant hosts due to its economic and nutritional relevance, its plasticity to be cultivated under diverse soils and climates, and consumed fresh or processed. The most common pathogenic Fusarium species are Fusarium oxysporum f. spp. lycopersici, Fusarium oxysporum f. sp. radicis-lycopersici, and Fusarium solani. However, the species presence and prevalence depend on the globe region, and other species can be found such as F. semitectum, F. oxysporum, F. equiseti, F. falciforme, or F. striatum. Most of these species’ strains are also mycotoxigenic and can potentially contaminate tomatoes and tomato-based products with several mycotoxins. Some cases of mycotoxin contamination on tomatoes were reported and caused by different fungal species. Emerging Fusarium mycotoxins have recently been reported and gained high interest due to their increasing frequency. These mycotoxins, still not deeply studied, may constitute high-risk factors for human and animal health. This chapter is dedicated to the most relevant Fusarium spp. affecting tomato crops and the consequences of consuming mycotoxin-contaminated fresh tomatoes or industrially processed and describes some promising biocontrol measures.