Most nashi cultivars require heavy thinning, and this has traditionally been performed by the time and labour-intensive practice of hand thinning. Crop load management is a key cost driver for nashi production, but there are limited cost-effective options available for nashi growers compared to other pome fruit, especially apples and, to a lesser extent, European pears. There is, however, potential to adapt some of the thinning tools and techniques used in apples and European pears to reduce the labour requirements and high cost of thinning in nashi, thus improving industry profitability. Several chemical thinning agents have potential for nashi, and an understanding of the optimal application rates, times and weather conditions for each chemical, as well as the conditions/factors that impact the tree carbon balance, will improve the predictability of chemical thinning. However, it is difficult to target specific flowers/fruitlets within a cluster with chemicals, and the flowers that produce the preferred fruit shape and size are in the middle of the flower cluster. Mechanical thinning during the flowering period with either Darwin or BAUM-style string thinners has potential, particularly as these devices can be used as early as flower emergence. As for chemical thinning, the issue of non-selectivity needs to be addressed; however, the development of mechatronic systems should overcome most problems that occur with the currently available mechanical thinners. Shading at critical times is an avenue that could be explored further to ascertain the critical stage when developing fruit are susceptible to enable the determination of the optimal timing and duration of shading. Targeted pruning and bud thinning during the dormant winter period to reduce the floral bud numbers is a valuable option for the precise placement of fruit in optimal positions and to set up the required number of clusters. This review highlighted several tools/techniques that, with further work, can be incorporated into a systematic approach to crop load management in nashi while reducing the risk and cost.