Bacterial wilt, caused by Ralstonia solanacearum, is a major threat for tomato farmers, especially in tropical areas. This study investigates the prevalence and management of bacterial wilt disease in Coimbatore district, Tamil Nadu, over three growing seasons (2020–2023). The survey found the disease occurrence in Kinathukadavu, Madukarai and other blocks with severe incidence during the Rabi season. An Integrated Disease Management (IDM) approach, incorporating soil amendment, soil application of Bacillus subtilis, intercropping marigold and seedling root dipping of streptocycline and drenching with copper-based fungicides, was evaluated in field trials over three consecutive years. IDM treatment (T6) consistently resulted in the lowest disease incidence, ranging from 2.67 to 4.47 % and the highest yield (394.50-404.63 q/ha) and Benefit: Cost (B: C) ratio (3.91-3.63) over the study period, demonstrating its cost-effectiveness compared to other treatments. A strong negative correlation between wilt incidence and yield was observed, with IDM T6 yielding the best results. These findings suggest that Integrated Disease Management (IDM) is an effective and sustainable approach for managing bacterial wilt disease and improving tomato yield in affected regions.