Patulin is produced by species of Penicillium, Aspergillus and Byssochlamys. It is a mycotoxin that primarily contaminates pome fruit products, but is being reported from other fruit and foods, for example shellfish and cheese. New findings reveal that patulin binds to the bases of DNA, in addition to its well-established ability to conjugate sulfhydryl groups. Novel cellular targets are also being uncovered. In the EU, patulin levels in apple products are now mostly below specified limits. Biocontrol agents either prevent infection by mycotoxigenic fungi or lower patulin levels. More knowledge about critical control points, the role of patulin in plant disease, and the environmental cues that stimulate patulin production will enable the tailoring of effective, future control measures.