Pangasius aquaculture has emerged as a dominant industry in Southeast Asia, poised to lead global production by 2022 due to its nutritional value, adaptability, and economic viability. Its significance is driven by consumer demand for affordable, high-quality fish. The research underscores nutritional benefits and farming advantages of Pangasius species, crucial for enhancing global food security. However, challenges in disease management and environmental sustainability persist, exacerbated by intensified farming practices. Effective disease control in Pangasius aquaculture involves medicated feeds, vaccination programs, and alternative therapies like herbal remedies and immunostimulants. Disease management strategies integrate biosecurity measures and sustainable practices to minimize disease outbreaks and ensure industry resilience. Future efforts should focus on addressing emerging diseases and antimicrobial resistance through enhanced surveillance, vaccine development, and alternative therapies, balancing environmental and public health concerns for sustainable aquaculture practices.