The fungal species Sporisorium scitamineum causes sugarcane smut and is a severe pathogen in China that imposes substantial yield losses on sugar production throughout the country. As this disease is one of the main diseases found in most places cultivating sugarcane, namely in Guangxi, Yunnan, and Guangdong, it becomes very challenging for breeders who want to breed disease-resistant varieties. Sugarcane is complex at the genetic level, and the pathogen has an adaptive ability that makes it challenging to breed for durable resistance. Although traditional breeding techniques are fundamental, they can never keep pace with the rate of adaptation of the pathogen. Recent developments in molecular breeding, such as MAS, genomics, and transgenic approaches, are promising tools for enhancing resistance efficiency. However, such breeding techniques are hard to apply in large-scale breeding programs since the crop has a long breeding cycle, and variability is high with a demand for improvement of multiple traits. The paper outlines the current status of sugarcane smut disease in China. It discusses developing disease-resistant varieties and possible solutions to this ravaging disease through newly developed technology. Recent developments in omics technologies, transcriptomics, proteomics, and metabolomics contribute to our understanding and insight into resistance and susceptibility mechanisms. This will further our knowledge about smut and its interaction with sugarcane genotypes and thus support the development of durable, resistant varieties for sustainable sugarcane in years to come.