Abstract Fusarium culmorum and F. graminearum Groups 1 and 2 cause seedling blight, crown rot, foot rot and head blight in wheat and rye that may affect grain yield and quality for baking and feeding. This review starts with an analysis of Fusarium populations with regard to their genetic variation for aggressiveness, mycotoxin production, and isolate‐by‐host genotype interaction. To assess resistance in the different host growth stages, quantitative inoculation and disease assessment techniques are necessary. Based on estimated population parameters, breeding strategies are reviewed to improve Fusarium resistance in wheat and rye. Epidemiological and toxicological aspects of Fusarium resistance that are important for resistance breeding are discussed. F. culmorum and F. graminearum display large genetic variation for aggressiveness in isolate collections and in naturally occurring populations. The production of mycotoxins, especially deoxynivalenol and its derivatives, is a common trait in these populations. Significant isolate‐by‐host genotype interactions were not found across environments in wheat and rye.Artificial infections in the field are indispensable for improving Fusarium crown rot, foot rot and head blight resistance in wheat and rye. For a reliable disease assessment of large populations, disease severity ratings were found to be the most convenient. The differentiation of host resistance is greatly influenced by an array of nongenetic factors (macro‐environment, microclimate, host growth stage, host organ) that show significant interactions with host genotype. Selection for environmentally stable resistance has to be performed in several environments under a maximum array of different infection levels. Selection in early growth stages or on one plant organ does not in most cases allow prediction of resistance in adult‐plant stages or another plant organ.Significant genetic variation for resistance exists for all Fusarium‐incited diseases in breeding populations of wheat and rye. The patho‐systems studied displayed a prevalence of additive gene action with no consistent specific combining ability effects and thus rapid progress can be expected from recurrent selection. In wheat, intensive testing of parental genotypes allows good prediction of the mean head blight resistance after crossing. Subsequent selection during selfing generations enables the use of transgression towards resistance. In hybrid breeding of winter rye, the close correlation between foot rot resistance of inbred lines and their GCA effects implies that selection based on the lines per se should be highly effective. This is not valid for F. culmorum head blight of winter rye caused by a greater susceptibility of the inbred lines compared to their crosses.For both foot rot and head blight resistance, a high correlation between the resistance to F. graminearum and F. culmorum was found in wheat and rye. Mycotoxin accumulation occurs to a great extent in naturally and artificially infected plant stands. The correlation between resistance traits and mycotoxin contents are medium and highly dependent on the environment. Further experiments are needed to clarify whether greater resistance will lead to a correlated reduction of the mycotoxin content of the grains under natural infection.