Hailed as the single most important paper published on crop protection in the 20th century, Stern et al. in 1959 formed the conceptual basis for modern integrated pest management (IPM) worldwide. The ecological foundation for IPM envisioned by its authors is as valid today as in 1959. However, adoption by developing country farmers has been low and its advances short-lived. The present paper examines the concept of integration in IPM and criteria for determining whether its control tactics have been integrated harmoniously. The effects of local and regional landscape patterns on pests and on the design of IPM are reviewed, arguing that the agroecosystem must be understood and managed as a living system with the goal of enhancing and conserving agrobiodiversity and keeping ecosystem services intact. Key to IPM adoption is convincing farmers to integrate non-chemical alternatives (e.g. biological control, plant diversification) as primary management components and to apply pesticides judiciously and only after non-chemical components fail to manage pests effectively. Research, extension and policy changes are identified to increase the efficiency, adoption and sustainability of IPM on resource-limited farms. The over-arching challenge is devising communication and support systems that allow resource-limited farmers to try, adopt and sustain IPM that enhances yields and profits in light of the many uncertainties and challenges. Use of information technology, media development, crowdsourcing and rural sociology is advocated to connect farmers to the technical sources required to enhance yields and profits and reduce risks to them, the farming community and the environment.