Green mold disease caused by pathogenic Trichoderma spp. (such as T. aggressivum, T. harzianum, and T. pleurotum) is a major threat to the production of commercial mushrooms, including Agaricus bisporus, Pleurotus ostreatus, and Lentinula edodes. Trichoderma spp. act as aggressive competitors and mycoparasites that rapidly colonize substrates, secrete cell walldegrading enzymes, and release toxic metabolites, severely inhibiting host mycelial growth and yield. This review summarizes current knowledge on the diversity, epidemiology, and cellular interaction mechanisms of pathogenic Trichoderma spp. in cultivated mushrooms. We also evaluate the existing control strategies, including substrate pasteurization, chemical fungicides, biocontrol agents, and resistance breeding. Future directions for advancing eco-friendly integrated pest management (IPM) frameworks for sustainable mushroom cultivation are discussed.