Post-harvest losses in horticultural crops represent a critical challenge to global food security, with approximately 20-40% of fresh produce lost between harvest and consumption. These losses occur at multiple stages of the supply chain, including harvesting, handling, storage, processing, transportation, and marketing. Horticultural crops, being highly perishable due to their high moisture content and respiratory activity, are particularly vulnerable to post-harvest deterioration. This comprehensive review examines the magnitude, causes, and consequences of post-harvest losses in fruits and vegetables, analyzing factors contributing to deterioration including physiological processes, pathological infections, mechanical damage, and environmental conditions. The study explores innovative management strategies including improved harvesting techniques, cold chain management, modified atmosphere packaging, edible coatings, and advanced storage technologies. Economic analysis reveals that post-harvest losses result in annual global economic losses exceeding $310 billion, disproportionately affecting smallholder farmers in developing countries. Effective post-harvest management requires integrated approaches combining technological innovations, infrastructure development, capacity building, and policy interventions. The implementation of comprehensive post-harvest management systems can significantly reduce food wastage, enhance farmer incomes, improve nutritional security, and contribute to environmental sustainability.