The multispecies (spp.) plant genus Opuntia (commonly referred to as cactus pear) plays a significant socioeconomic, environmental and nutritional role for many countries in the Near East and North Africa (NENA) region, which comprises 18 member countries of the Food and Agriculture Organization of the United Nations (FAO). Opuntia spp. are mainly used here for their fruit (human consumption as well as cosmetic and pharmaceutical applications), land rehabilitation, and fodder for livestock. While cactus pear has been cultivated for thousands of years in North and South America, Opuntia spp. is relatively new to NENA. Its earliest recorded history of cultivation in the region is 1770 in Morocco, followed by Tunisia from 1920–1930. Countries such as Jordan, the Syrian Arab Republic and Lebanon have been cultivating it for only about 60 years. Cactus production is becoming an increasingly popular source of livelihoods in the drylands. When a foreign plant species is introduced into a new environment, pests and diseases are relatively few. This has been the case for cactus pear in the NENA region until recently. One of the major pests that threaten Opuntia spp. worldwide is Dactylopius opuntiae (D. opuntiae), commonly known as prickly pear cochineal. The pest is a red scale insect that originated in Central and South America. Some countries in South America grow other species of cochineals (D. coccus) for economic reasons, e.g. their bright red carmine dye, though this is decreasing due to limited market demand. The presence of cochineal is most noticeable on the plant when the nymphs secrete a white wax over their bodies, turning the cactus white in colour. For most cactus pear producers, this pest is a significant threat to their production if the infestation is not properly treated and controlled. Outbreaks can decimate orchards, destroying them completely in only a matter of months, devastating the livelihoods that depend on them. Presence of this pest in the NENA region was first recorded in Lebanon in 2012. Since then, rapid cochineal spread has been officially documented in Jordan, Lebanon, the Syrian Arab Republic and Morocco with differing levels of significance. This report details that most countries were unprepared for the outbreak. Lack of knowledge of the pest and slow action to establish quarantine areas led to its rapid spread. Cochineal is thought to have spread in the region through the trading of cactus cladodes (pads) and fruits. Management and containment of outbreaks also differs on a country-by-country basis, with many farmers resorting to experimenting with different treatments. A lack of national urgency and planning in most countries has led to unsustainable and unhealthy practices, such as an over-dependency on chemical sprays and the use of fire.