Global food production must increase by 50% to meet the projected demand of the world’s population by 2050. Meeting this difficult challenge will be made even harder if climate change melts portions of the Himalayan glaciers to affect 25% of world cereal production in Asia by influencing water availability. Pest and disease management has played its role in doubling food production in the last 40 years, but pathogens still claim 10–16% of the global harvest. We consider the effect of climate change on the many complex biological interactions affecting pests and pathogen impacts and how they might be manipulated to mitigate these effects. Integrated solutions and international co-ordination in their implementation are considered essential. Providing a background on key constraints to food security, this overview uses fusarium head blight as a case study to illustrate key influences of climate change on production and quality of wheat, outlines key links between plant diseases, climate change and food security, and highlights key disease management issues to be addressed in improving food security in a changing climate.