Growers have enthusiastically embraced crops genetically modified to express Bacillus thuringiensis (Bt) proteins for insect control because they provide excellent protection from key damaging insect pests around the world. Bt crops also offer superior environmental and health benefits while increasing grower income. However, insect resistance development is an important concern for all stakeholders, including growers, technology providers and seed companies that develop these genetically modified crops. Given the marked benefits associated with Bt crops, insect resistance management (IRM) must be a consideration when cultivating these crops. The technical data and practical experience accumulated with Bt crops in many global regions can inform different aspects of resistance management leading to robust, science-based IRM plans. A range of elements should be considered in assembling any IRM strategy, including: pest biology/ecology, product deployment patterns, local cropping systems, insect susceptibility monitoring, stakeholder/grower communications, and a remedial action plan should resistance develop. Each of these elements is described in more detail, with specific examples of how these elements can be combined and tailored to the local/regional environments and grower practices. IRM plans need to be suitable for the given production situation. What works for large monoculture production systems in North America is unlikely to be appropriate for the small, more diverse agriculture of southeast Asia or Africa. Though it is clear that Bt crops impart considerable value to growers, it is also clear that it is in the best interest of all stakeholders to preserve Bt proteins for the long-term benefits they provide.