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Simple Summary: Diabrotica virgifera virgifera LeConte, the Western corn rootworm (WCR), is a maize-specific pest that has been a serious threat in Europe since the mid-1990s. To properly implement integrated pest management, it is necessary to identify the key factors associated with risks of crop damage from WCR and to evaluate the effectiveness of area-wide strategies based on agronomic measures, such as crop rotation, in reducing those risks. In Italy and Croatia, a survey of agronomic and cultural factors in fields damaged by WCR allowed us to determine that the beetle population size accounts for most of the risk of maize damage from WCR. Crop rotation (without insecticide use), both structural and flexible, was the most effective strategy for keeping WCR populations below the damage threshold. This indicates that WCR management can be carried out in accordance with European Union regulations to limit or avoid insecticide treatments and reduce environmental impacts. The Western corn rootworm (WCR), Diabrotica virgifera virgifera LeConte, has been a serious quarantine pest to maize in Europe since the mid-1990s. The integrated pest management of WCR requires an accurate knowledge of the factors that contribute most to risks of crop damage, as well as knowledge of effective area-wide strategies based on agronomic measures, such as crop rotation. In Italy and Croatia, agronomic and cultural factors in fields damaged by WCR were evaluated through a long-term survey. Based on the survey results, high-WCR densities contribute most to risks of damage to maize. Extensive field research in north-eastern Italy compared large areas of continuous maize production with areas under different crop rotation systems (i.e., a structural one with one-time maize planting in a three-year rotation and a flexible one with continuous maize planting interrupted when beetle populations exceed the threshold). The objective was to evaluate the effectiveness of different rotation regimes as possible best practices for WCR management. Captures of beetles in yellow sticky traps, root damage, larval densities, and damage to maize plants (e.g., lodging) were assessed at the center of each area. The results demonstrated the both structural and flexible crop rotation systems were effective strategies for maintaining WCR below damage threshold densities without the need for insecticides. [ABSTRACT FROM AUTHOR]