Sugarcane is a major crop cultivated globally for sugar production, especially in tropical and subtropical areas. Sugarcane breeding has evolved significantly, combining traditional hybridization with advanced biotechnological tools to improve yield, disease resistance, and stress tolerance. Current breeding programs focus on developing high-sucrose, high-biomass varieties with adaptability to diverse agro-climatic conditions. Key achievements include the development of disease-resistant cultivars and the incorporation of wild germplasm to enhance genetic diversity. Genomic selection, marker-assisted selection breeding, and the clustered regularly interspaced short palindromic repeats (CRISPR) techniques can potentially support the breeding process for developing better cultivars. Advanced production technologies that may be employed to enhance sugarcane efficiency-production and processing are limited due to economic, social, and regulatory constraints, especially in the regions of developing nations. Disease-free, climate adaptation, and better agronomic traits should be incorporated in the breeding programs for sustainable sugarcane in years to come. This chapter reviews the current status of sugarcane breeding, highlighting key developments in conventional hybridization, molecular marker-assisted selection, genomic breeding, and genetic engineering. It also explores the integration of wild germplasm to broaden genetic diversity and improve adaptive traits.