Fire blight is a devastating disease of apple and pear, and the management of fire blight is challenged by the evolution and spread of streptomycin resistance in the pathogen population. Understanding how streptomycin resistance is distributed and spread not only will help the growers to adopt the most appropriate management options, but also will provide indications of how to avoid promoting and spreading streptomycin resistance in the future. In this presentation, we reviewed the disease biology, management options, the history and current updates of the streptomycin resistance in North America, and presented the most recent research updates on the identification of alternatives for antibiotics in fire blight management. By the end of this presentation, the practitioner should have a better understanding of the appropriate management practices that help to restrict the development and spread of streptomycin resistance, and the alternative tools that are currently available and underdevelopment for fire blight management.