Italy is one of the main apple producers in Europe, primarily intended for fresh consumption, both in the domestic and foreign markets. Fruit yield and quality depends on the cultivar, rootstock, and management practices, such as the fertilization and irrigation adopted in the orchard. This review aims at reporting the main apple cultivars and rootstocks, the management of fertilization and irrigation, as well as their adaptation to apple tree orchards in Italy. The programs for genetic improvement carried out in this country involved the selection of apple tree cultivars and rootstocks which enable a high fruit yield and quality, in order to meet the requirements from the consumer market. In the fertilization and irrigation management, nutrients and water are supplied in amounts next to the actual need of the plants, providing an adequate nutrition, a satisfactory yield, and high quality fruits, besides preventing, whenever possible, nutrients and water losses in the environment.