Purpose of Review: Forest research has shown for a long time that microorganisms influence tree-insect interactions, but the complexity of microbial communities, as well as the holobiont nature of both trees and insect herbivores, has only recently been taken fully into account by forest entomologists and ecologists. In this article, we review recent findings on the effects of tree-insect-microbiome interactions on the health of tree individuals and discuss whether and how knowledge about tree and insect microbiomes could be integrated into forest health management strategies. We then examine the effects tree-insect-microbiome interactions on forest biodiversity and regeneration, highlighting gaps in our knowledge at the ecosystem scale. Recent Findings: Multiple studies show that herbivore damage in forest ecosystems is clearly influenced by tripartite interactions between trees, insects and their microbiomes. Recent research on the plant microbiome indicates that microbiomes of planted trees could be managed at several stages of production, from seed orchards to mature forests, to improve the resistance of forest plantations to insect pests. Therefore, the tree microbiome could potentially be fully integrated into forest health management strategies. Summary: To achieve this aim, future studies will have to combine, as has long been done in forest research, holistic goals with reductionist approaches. Efforts should be made to improve our understanding of how microbial fluxes between trees and insects determine the health of forest ecosystems, and to decipher the underlying mechanisms, through the development of experimental systems in which microbial communities can be manipulated. Knowledge about tree-insect-microbiome interactions should then be integrated into spatial models of forest dynamics to move from small-scale mechanisms to forest ecosystem-scale predictions.