Melanaphis sorghi is a pest that is native to Africa but is now distributed worldwide. In 2013, its destructive capacity was demonstrated when it devastated sorghum crops in the United States and Mexico, making it a new pest of economic importance in North America. At the time, the phytosanitary authorities of both countries recommended the use of pesticides to control the outbreak, and biological control products for the management of this pest were not known. In response to the outbreak of M. sorghi in North America, several field studies have been performed in the last decade on sorghum crops in the USA and Mexico. Works have focused on assessing resistant sorghum hybrids, pesticide use, and recruitment of associated aphid predators and entomopathogens for natural control of M. sorghi populations. The objective of this review is to compile the information that has been generated in the past decade about indigenous enemies affecting M. sorghi naturally in the field, as well as the search for biological control alternatives and evaluations of interactive effects of resistant sorghum hybrids, pesticides, and natural enemies. To date, different predators, parasitoids, fungi, and bacteria have been evaluated and in many cases found to affect M. sorghi populations in sorghum agroecosystems or laboratory bioassays, and the use of resistant sorghum varieties and pesticides did not have clear toxic effects on natural enemy populations. Many of the macroorganisms and microorganisms that have been evaluated as potential biological controls have shown potential as alternatives to synthetic pesticides for keeping M. sorghi population densities below economic damage thresholds and are compatible with integrated management of sorghum aphids. While most tests of these biological alternatives have shown that they have aphidicidal potential against sorghum aphids, it is crucial to take into account that their effectiveness in the field depends on a number of abiotic and biotic factors, including soil texture, temperature, humidity, and natural enemies.