The state of the art in Fusarium head blight resistance research is reviewed with reference to breeding for genetic resistance to Fusarium in wheat in practice. Fusarium graminearum and F. culmorum produce the trichothecene mycotoxin deoxynivalenol (DON). DON has phytotoxic properties and is an important aggressiveness factor in head blight. Head blight resistance in wheat is not specific for either F. graminearum or F. culmorum. Resistance components include resistance to penetration, resistance to colonization and mechanisms that influence kernel DON content. The resistance to Fusarium in wheat is a quantitative trait with relative high heritability and controlled by a few genes with major effect. A major quantitative trait locus (QTL) for head blight resistance from the Chinese variety Sumai 3 has been identified and verified by several research groups via molecular marker analysis. Research is now directed at identifying additional QTLs to make accumulation of resistance genes in elite wheat lines possible. The policy of official variety list trials may affect the head blight resistant level of future wheat varieties by excluding candidate varieties that are a too susceptible to Fusarium. A higher level of Fusarium head blight will guarantee lower risks for the farmer of crop loss due to reduced grain yield, low quality and mycotoxin contamination.