High tunnels have been used in the United States for more than 50 years, and growers are encouraged to use them more frequently through government cost-share programs. Research on fruits and vegetable production systems has focused on high value crops such as tomato, salad greens, and several fruit crops. Maintaining soil quality and controlling insects and diseases are all issues that growers face. This review looks at current research on these issues as well as economic considerations addressed in the scientific literature. Global statistics and reports are also reviewed that complement the North American studies. Gaps in our understanding are identified, and directions for future research are suggested.