Mycotoxins, secondary metabolites produced by pathogenic fungi such as Fusarium, Aspergillus, Penicillium, and Alternaria pose a significant threat to global food safety and agricultural productivity. These toxins often arise concurrently with plant diseases, particularly under favorable environmental conditions that enhance fungal infection and colonization. Climate change, characterized by rising temperatures, altered precipitation patterns, and increased frequency of extreme weather events, is amplifying the occurrence and severity of both plant diseases and mycotoxin contamination. This research provides a comprehensive overview of the ecological, physiological, and molecular interplay between mycotoxigenic fungi and their host plants. We investigate how climate variables impact mycotoxin biosynthesis and pathogen virulence, as well as how host responses can be compromised under abiotic stress. Advanced omics technologies, smart diagnostics, and artificial intelligence are presented as transformative tools for early detection, risk prediction, and integrated management. Emphasis is also placed on biological control strategies, resistance breeding, and postharvest innovations for mycotoxin mitigation. Finally, we discuss the importance of regulatory frameworks and region-specific surveillance systems, particularly in vulnerable agroecosystems of the Global South. Bridging plant pathology, toxicology, and climate science, this work highlights the urgent need for holistic, climate-resilient solutions to protect crop health and ensure food security in a changing world.