Grapevine (Vitis spp.) is one of the most important horticultural species, but also one of the most vulnerable to viral infections. To date, 102 viruses are known to infect grapevines. Of these, some viruses cause significant economic damage worldwide, affecting the quantity and quality production, plant growth and development, and the vineyards long-lasting. Other viruses have a broad spectrum, affecting several crop plants and represent scientific curiosities for the grapevine, both because they are rarely encountered and the damages induced are negligible. This paper summarizes the main knowledge regarding the diversity of viral agents affecting grapevine and the associated symptomatology characteristics. The economic effects of viral diseases are analyzed, highlighting their influence on propagation material and grape production. Once virus-infected, grapevine plants remain infected for their entire life. Prevention of infection includes the production of certified virus-free planting material and virus testing. Thus, the propagation of healthy material, originating from authorized sources, tested and certified as virus-free, is essential for sustainable viticulture. Also, virus-elimination methods are presented (meristem/shoot tip cultures, thermotherapy, in vitro chemotherapy, electrotherapy, cryotherapy, and combined methods), which allow the regeneration of healthy, virus-free plants. The integration of these technologies into virus-free germplasm selection and conservation programs represents a priority direction for a modern viticulture, ensuring the maintenance of grapevine health, the protection of genetic diversity and the sustainability of grapevine production.