This chapter explores the intricate relationship between international trade, pesticide use patterns and environmental sustainability. Pesticides, including herbicides, insecticides, fungicides and others, are widely utilized in agriculture to improve crop yields and ensure food security. Over the past few decades, the intensification of international trade has corresponded with a notable 50% increase in pesticide application from 1990 to 2022. The increase in pesticide use, driven by international trade, has reflected the environmental and health implications, especially in low-income regions where pesticide application has soared due to agricultural growth. This chapter also highlights the environmental effects of pesticide use, including biodiversity loss and risks to human health, emphasizing the need for sustainable agricultural practices. Climate change further affects the trade dynamics, as shifting pest patterns lead to increased pesticide dependency. Collaborative global efforts and stricter regulatory frameworks are critical to addressing the environmental and health challenges associated with pesticides while fostering a more sustainable global food system.