Wheat is the most consumed cereal worldwide and can be processed to different products for human consumption. This crop can be infected by Fusarium species, among them those within the Fusarium graminearum complex causing Fusarium head blight (FHB. The disease can severely reduce grain yield and quality under conditions of high humidity and warm temperatures during anthesis. Moreover the grains can be contaminated with mycotoxin such as trichothecenes, among them deoxynivalenol and their acetyl derivates 3-ADON, 15-ADON and DON-3-glucoside. Some years, depending on the environmental conditions Fusarium proliferatum can also infect the grain and fumonisin contamination can be observed. To understand the way of grain infection by Fusarium species will help to undertake strategies to reduce the problem both at pre-harvest and during processing to select adequate procedures to manage mycotoxin production. Different strategies at different stages of the wheat chain have been proposed to reduce the impact of FHB and mycotoxin accumulation.