Interest in organic fruit production, where management practices differ from those in conventional production, has expanded in recent years. Synthetic products are generally not allowed in organic fruit production; for example, in plant protection and nutrient supply, only natural products are permitted according to IFOAM standards. As a result, disease control in organic systems is less effective than in conventional or integrated production, and thus disease epidemics are likely to be more severe in such a system. This study describes the development of an apple scab management strategy. This includes epidemic features of the disease in organic orchards, a risk of scab epidemics initiated by sexual and asexual stages, possible control strategies against inoculum sources, efficacy and phytotoxicity of organically-approved fungicidal products, and appropriateness of various sanitation practices in organic fruit production. Also, the role of resistant vs. susceptible cultivars in disease epidemiology and management of organic orchards is considered. Based on the above examples encompassing mechanical, agro-technical, biological and chemical control options, a theoretical and practical decision-making approach and future trends in apple scab management are provided for organic orchards.