Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) is an invasive pest causing damage to tomato productionw worldwide. Synthetic chemical insecticides have proven unsustainable due to resistance development and adverse environmental impacts. Alternative control methods rarely provide sufficient control of T. absoluta when used alone. Their effectiveness can be enhanced by integrating them into combined approaches, where strategies reinforce each other to achieve more effective control. Although several combinations of alternative methods have been reported, a synthesis of which combinations have been tested, at what scales, and with what outcomes has been lacking. Here we evaluate the current state of knowledge on binary combinations of alternative control methods against T. absoluta. Based on 66 articles comprising 154 experiments identified through a systematic literature search, a Multi-Criteria Decision-Making framework was applied to assess effectiveness of the combinations across small, semi-field, and commercial scale trials. Our synthesis reveals valuable insights into combined control strategies but also shows that most studies remain confined to smallscale experiments. Current evidence supports prioritizing combinations with proven consistency across scales, especially commercial-scales, such as parasitoid-predator, predator-predator or plant extracts with non-arthropod biological control agents. Strategies relying on plant extracts with arthropod natural enemies frequently undermine efficacy and require cautious application. We highlight the urgent need for more commercial-scale trials, inclusion of controls testing agents alone, and economic assessments to evaluate cost-effectiveness and feasibility. This review provides the first evidence-based roadmap directly relevant to researchers, farmers, and policymakers engaged in crop protection and IPM development against T. absoluta and beyond.