Experiments investigating effects of foliar disease control on wheat grain protein concentration (GPC) are reviewed. Fungicidal control of rusts (Puccinia spp.) and powdery mildew (Erysiphe graminis) increased or had no significant effect on GPC in almost all cases, whilst control of the Septoria spp. often resulted in reduced GPC, but with exceptions. Reasons for these differences are discussed with reference to host pathogen interactions. Irrespective of infection strategy (biotrophic or necrotrophic), controlling severe infection increased nitrogen yield and the proportion of above-ground crop nitrogen that was partitioned to the grain. Similar effects are recorded for above-ground biomass and dry matter harvest index. The relationships between fungicide effects on green flag leaf area duration (GFLAD) and GPC were examined and shown to be unaffected by mode of action of the fungicide. Interactions between fungicide use and cultivar, nitrogen and growing season are related to the amount and type of pathogen present, and environment. An economic analysis demonstrated that fungicide effects on GPC should not affect the choice of fungicide or application programme, but that applications of foliar urea at the start of grain filling can deliver a cost-effective method of eliminating GPC reductions that may occasionally result from fungicide use.