Climate change poses unprecedented challenges to global food systems, threatening agricultural productivity, supply chain stability, and nutritional security through increasing temperatures, extreme weather events, and shifting growing zones. Controlled and precision fermentation technologies have emerged as transformative platforms for climate-resilient food production, offering decoupling from weather-dependent agriculture, reduced environmental footprints, and enhanced resource efficiency. This review examines the technological foundations, climate-resilient applications, sustainability implications, and future trajectories of controlled and precision fermentation systems within the context of sustainable food production. The scope encompasses microbial engineering and strain selection for optimized performance, advanced bioreactor design incorporating smart monitoring and automated parameter control, and digital technologies including real-time biosensors, artificial intelligence optimization, and predictive modeling for data-driven fermentation management. Key climate-resilient applications are examined across fermented alternative proteins, functional and fortified foods, low-input fermentation systems adapted to resource-constrained environments, and integration with circular bioeconomy models that valorize waste streams. The review further addresses sustainability assessment through life cycle analysis of energy efficiency, carbon footprint reduction, water use optimization, and closed-loop systems. Techno-economic feasibility, regulatory frameworks, food safety considerations, and consumer acceptance are critically evaluated as determinants of industrial implementation. Key challenges including scale-up limitations, standardization requirements, and the digital divide in agri-food systems are analyzed alongside emerging innovation pathways. By synthesizing current scientific knowledge and identifying strategic research directions, this paper concludes that controlled and precision fermentation systems represent pivotal technologies for building climate-resilient, environmentally sustainable, and nutritionally adequate food systems capable of meeting the demands of a growing global population under changing climatic conditions.