Transgenic cotton that produced one or more insecticidal proteins of Bacillus thuringiensis (Bt) was planted on over 15 million hectares in 11 countries in 2009 and has contributed to a reduction of over 140 million kilograms of insecticide active ingredient between 1996 and 2008. As a highly selective form of host plant resistance, Bt cotton effectively controls a number of key lepidopteran pests and has become a cornerstone in overall integrated pest management (IPM). Bt cotton has led to large reductions in the abundance of targeted pests and benefited non-Bt cotton adopters and even producers of other crops affected by polyphagous target pests. Reductions in insecticide use have enhanced biological control, which has contributed to significant suppression of other key and sporadic pests in cotton. Although reductions in insecticide use in some regions have elevated the importance of several pest groups, most of these emerging problems can be effectively solved through an IPM approach.