This review focuses on the process of adapting the original concept of Integrated Pest Management (IPM) to the wider conception of the Integrated Fruit Production (IFP) implemented in Europe. Even though most of the pest management strategies still rely on the use of synthetic pesticides, a wide array of innovative and environmentally friendly tools are now available as possible alternative to the pesticides within the modern apple production system. We also highlight how recent pest management strategies and tools have created an opening for research towards IPM improvement, including the use of biorational pesticides, semiochemicals and biological control. Forecasting models, new tree training systems and innovative spray equipment have also been developed to improve treatment coverage, to mitigate pesticide drift and to reduce chemical residues on fruits. The possible threats that jeopardize the effective implementation of IPM and particularly the risks related to the development of the pesticide resistance and the introduction of new invasive pests are also reviewed. With the directive 128/09, the European legislation recognizes IPM as a strategic approach for the sustainable use of pesticides. Within this context, IPM and related guidelines is called to meet different areas of concern in relation to the worker and bystander safety. Beside the traditional economic criteria of the market-oriented agriculture, sustainable agriculture includes the assessment of the environmental impact of the agronomic practices within the societal context where they take place. As a consequence of the raising consumer concerns about environmental impacts generated by the fruit production, IFP certification over product standards, including process aspects, are frequently required by consumers and supermarket chains.