Significant losses in harvested fruit can be directly attributable to decay fungi and quality deterioration. Hot water treatment (HWT) has been demonstrated to be an effective and economic environment-friendly approach for managing postharvest decay and maintaining fruit quality. In this study, the effects of HWT (45 °C for 10, 15, 20, and 25 min) on in vitro growth of Fusarium oxysporum, in vivo Fusarium rot, and natural decay of melon were investigated. HWT inhibited spore germination and germ tube elongation of F. oxysporum. Protein impairment and ATP consumption triggered by HWT contributed to the inhibitory effect. Results of in vivo studies showed that HWT effectively controlled Fusarium rot and natural decay of melon. Correspondingly, HWT induced a significant increase in content of total phenolic compounds and lignin of melon. These findings indicate that the effects of HWT on Fusarium rot may be associated with the direct fungal inhibition and the elicitation of defense responses in fruit. Importantly, HWT used in this study had beneficial effects on fruit quality as well. HWT may represent an effective non-chemical approach for management of postharvest Fusarium rot.