The recent surge in demand for exotic ornamental crops such as orchids has led to a rise in international production, and a sharp increase in the number of plant and plant products moving between countries. Along with the plants, diseases are also being transported and introduced into new areas. Fusarium is one of the major diseases causing pathogens infecting orchids that is spreading through international trade. Studies have identified several species of Fusarium associated with orchids, some are pathogenic and cause symptoms such as leaf and flower spots, leaf or sheath blights, pseudostem or root rots, and wilts. Infection and damage caused by Fusarium reduces the quality of plants and flowers, and can cause severe economic losses. This review documents the current status of the Fusarium-orchid interaction, and illustrates challenges and future perspectives based on the available literature. This review is the first of Fusarium and orchid interactions, and integrates diverse results that both furthers the understanding and knowledge of this disease complex, and will enable the development of effective disease management practices.