The wheat stem sawfly, Cephus cinctus Norton (Hymenoptera: Cephidae), is historically one of the most important economic insect pests in the northern Great Plains of North America. Within this geographical region, the areas subjected to greatest attack are southern Alberta and Saskatchewan, southwestern Manitoba, eastern and northern Montana, North Dakota, northern South Dakota, and western Minnesota. Cumulative grain-yield losses and annual economic losses associated with this pest can exceed 30% and $350 million, respectively. Solid-stemmed cultivars of common wheat, Triticum aestivum L. (Poaceae), tolerant of infestation, are critical for C. cinctus management, but outbreaks of this pest continue to occur even after six decades of cultivar development. Furthermore, chemical control (a primary control option for other cereal (Poaceae) insect pests) has proven ineffective; this underscores the need to integrate resistant cultivars into a comprehensive integrated pest management program. We provide overviews of wheat stem sawfly biology, recent advances in applied research, the efficacy and integration of cultural and biological management strategies, and future directions for global research activities to manage wheat stem sawfly.