Research on the pathogen components involved in Fusarium head blight (FHB) along with the effects of their interactions on disease development and mycotoxin accumulation is reviewed. The fungal components within the FHB complex differ significantly in different environments. Individual species may respond differently to, and be differentially influenced by, particular disease control measures. Almost all published co-inoculation studies on wheat spikes or grains show that competitive interactions among FHB pathogens are the rule when fungal/disease development is considered. However, the fungi with the competitive advantage do not usually gain any advantage from the presence of other weaker competing fungi. Total mycotoxin production in mixed inoculations may decrease, increase, or remain unchanged compared with single-isolate inoculations, depending on the fungal species concerned and environmental conditions. A few recent studies, where each individual fungal component was quantified using molecular methods, suggest that mycotoxin productivity in mixed inoculations generally increases.