A complex of Fusarium species frequently infects maize, causing root, ear, and stem rot, yield losses, reduced seed quality, and mycotoxin accumulation. To quantify Fusarium species composition and mycotoxin contamination, we conducted a first nationwide monitoring in Swiss commercial grain maize over three years (2008–2010), followed by grain maize hybrid experiments across five sites (2011–2013). Samples were analysed for species incidence, fungal DNA, and the mycotoxins deoxynivalenol, zearalenone, and fumonisins. For each field, crop management data were collected. Fusarium graminearum, F. verticillioides, F. subglutinans, and F. proliferatum were predominant, and deoxynivalenol was the most frequent toxin, with 55% of the samples exceeding the European pig feed guidance value (0.9 mg kg−1). Overall, fumonisin contamination was low: only 11% of samples were above the limit of detection. The year, the length of the growing period, and the timing of the harvest were the principal determinants of F. graminearum infection and deoxynivalenol/zearalenone accumulation, whereas other agronomic factors, including crop rotation, soil management, and maturity class, showed only limited or inconsistent effects. Results from this study provide evidence that farmers should avoid long growing periods and late harvests to reduce the risk of high deoxynivalenol/zearalenone content. The maize hybrid experiments confirmed the overriding influence of weather conditions on Fusarium species incidence and mycotoxin content, leading to high inter-annual variability. These results highlight the need for standardised, long-term field experiments to disentangleagronomic effects and environmental drivers.