This article provides an overview of available systems for management of Fusarium mycotoxins in the cereal grain supply chain, with an emphasis on the use of predictive mathematical modeling. From the state of the art, it proposes future developments in modeling and management and their challenges. Mycotoxin contamination in cereal grain-based feed and food products is currently managed and controlled by good agricultural practices, good manufacturing practices, hazard analysis critical control points, and by checking and more recently by notification systems and predictive mathematical models. Most of the predictive models for Fusarium mycotoxins in cereal grains focus on deoxynivalenol in wheat and aim to help growers make decisions about the application of fungicides during cultivation. Future developments in managing Fusarium mycotoxins should include the linkage between predictive mathematical models and geographical information systems, resulting into region-specific predictions for mycotoxin occurrence. The envisioned geographically oriented decision support system may incorporate various underlying models for specific users' demands and regions and various related databases to feed the particular models with (geographically oriented) input data. Depending on the user requirements, the system selects the best fitting model and available input information. Future research areas include organizing data management in the cereal grain supply chain, developing predictive models for other stakeholders (taking into account the period up to harvest), other Fusarium mycotoxins, and cereal grain types, and understanding the underlying effects of the regional component in the models.