This review aims at providing a panorama of the main sustainable pest and disease management strategies for potato cultivation in Europe, with a particular focus on Integrated Plant Health Management (IPHM) approaches and their current challenges. Potato (Solanum tuberosum L.) is one of the most important food crops globally, but is exposed to numerous pests and diseases that significantly threaten tuber production. In light of increasing environmental concerns and the rise of pesticide- resistant pathogens and pests, alternative methods such as biological control, resistant cultivars and innovative techniques, such as attract-and-kill strategies, are gaining relevance. The European Union’s Directive 2009/128/EC has mandated the adoption of IPHM for annual crops, accelerating research and implementation efforts in this area. Despite recent progress in this area, several limitations affect the current body of evidence. The effectiveness of biological control agents often varies between laboratory and field trials, limiting their general on farm use. In addition, some pest monitoring methods—such as those for the soil-dwelling wireworms— lack validated thresholds, resulting in less reliable decision-making. Finally, the scarcity of long-term and large-scale studies reduces the overall precision and dependability of the current IPHM strategies. Further research is needed to improve predictive models, develop resistant potato varieties and enhance the consistency of biocontrol methods. The widespread adoption of effective, sustainable pest-management strategies will be crucial to safeguarding potato production, reducing the environmental impact of agriculture and ensuring food security.