Honeybees (Apis mellifera) play a key role in sustaining both global biodiversity and agricultural productivity. However, escalating declines in bee populations — largely driven by multifactorial stressors such as climate change, habitat loss, and notably, infestations by the parasitic mite Varroa destructor — pose significant threats to food security and rural economies. Traditional chemical treatments, despite their initial efficacy, have become increasingly problematic due to the emergence of chemical resistance, residue contamination, and adverse environmental impacts. This comprehensive review critically examines the current state of sustainable Varroa management, with a particular focus on the potential of thermotherapy. Thermotherapy, utilising controlled heat exposure, demonstrates high levels of mite mortality without compromising colony health, while complementary methods such as drone brood removal and organic acid applications further enhance the resilience of bee populations. By evaluating diverse technologies and their scalability, this paper advocates for a multidisciplinary approach that integrates advanced monitoring systems and innovative control mechanisms, and integrated pest management (IPM) strategies. Ultimately, the adoption of eco-friendly technologies is imperative to secure the long-term viability of apiculture and the essential ecosystem services it provides.