The global market for total organic product sales was $20 billion in 2005, continuing an annual growth rate of 20% to 35%. In the United States, there were 937,000 ha of certified organic land in 2003 with 5626 ha of organic apples [Malus sylvestris (L.) Mill var. domestica (Borkh.) Mansf.]. Increases in organic fruit production have been associated with improved pest management methods, the use of disease-resistant cultivars, and organic-focused marketing schemes. Often constrained by lower apple yields and smaller fruit size compared with conventional counterparts, key challenges for organic growers include regulation of nutrient cycling processes to maintain crop yields while minimizing the need for external inputs. In local or regional organic markets, disease-resistant apple cultivars, such as ‘Enterprise’, ‘Liberty’, ‘Redfree’, and ‘Gold Rush’, have gained increased acceptance, whereas exporting countries have continued their use of cultivars susceptible to scab [Venturia inaequalis (Cooke)]. Integrated insect pest management approaches, including the use of kaolin clay, codling moth granulosis virus, and spinosad-based insecticides, have been successfully developed to comply with export standards and quarantines, and to meet market demand. Key pests, such as codling moth [Cydia pomonella (L.)], have been managed at damage levels less than 5% using these approaches. Future pest management strategies in organic apple production will focus on development of scab-resistant cultivars with enhanced storage capability and reduction in inputs associated with negative environmental and health effects.