Mycotoxin contamination levels in maize kernels are controlled by a complex set of factors including insect pressure, fungal inoculum potential, and environmental conditions that are difficult to predict. Methods are becoming available to control mycotoxin-producing fungi in preharvest crops, including Bt expression, biocontrol, and host plant resistance. Initial reports in the United States and other countries have associated Bt expression with reduced fumonisin, deoxynivalenol, and zearalenone contamination and, to a lesser extent, reduced aflatoxin contamination in harvested maize kernels. However, subsequent field results have been inconsistent, confirming that fumonisin contamination can be reduced by Bt expression, but the effect on aflatoxin is, at present, inconclusive. New maize hybrids have been introduced with increased spectra of insect control and higher levels of Bt expression that may provide important tools for mycotoxin reduction and increased yield due to reduced insect feeding, particularly if used together with biocontrol and host plant resistance.