The present review discusses that several diseases affect the growth and productivity of pearl millet such as downy mildew (Sclerospora graminicola) and rust (Puccinia substriata). Among these, downy mildew causes devastating problem in some pearl millet growing areas leading to a severe yield reduction. Some studies have been undertaken to investigate the gravity of the problems, epidemiology of the disease and control measures as well as genetic improvement of these diseases with reasonable successes, specially in the case of downy mildew. Besides several minor diseases affecting pearl millet are reported. Insects and weeds are of minor importance in pearl millet.