Purpose of Review <p>This review outlines trends and impact of antimicrobial resistance (AMR) on management strategies for <i>Mycoplasma genitalium</i> and provides a contemporary understanding of its association with sequelae.</p> Recent Findings <p>Global rises in macrolide- and fluoroquinolone-resistance mean resistance-guided strategies are integral to improving antibiotic use and cure and underpin the importance of emerging AMR surveillance. Incremental progress has been made in improving cure using available generic drugs, often in combination and prolonged regimens. Current data supports an association between <i>M. genitalium</i> and pelvic inflammatory disease, but further research is needed to generate a robust evidence-base for sequelae in women and men.</p> Summary <p> Clinicians are increasingly encountering <i>M. genitalium</i> infections that are challenging to cure. There is an urgent need for investment and support in the development and evaluation of new resistance-diagnostics, new classes of antimicrobials and co-ordinated global AMR surveillance, to enable timely public health responses that inform clinical practice.</p>