Grapefruits, or citrus in general, contribute importantly not only to human health but also to the economic because they can be exported worldwide. Thus, quality of them, especially the shape, is required more strictly. One of the most common incidences influencing the exporting standard is sheepnosing. Therefore, this review was made to investigate factors that contribute to sheepnosing and also potent cultivation techniques to control. It was affected by many factors, including  geographical location, rootstock, irrigation and fertilization. Sheepnosing can become severe in not only quality but also quantity, when fruits face one of these conditions, including low humidity, high temperature, large day/night temperature gap, budded to sour orange, microjet irrigation, high N fertilization and low K fertilization. Up to now, there is a lack of methods that can predict the sheepnosing incidence in grapefruit, and among the factors, the proper use of fertilizers is the controllable one. Thereby, good and balanced fertilizations are needed. For that demand, an application of both the diagnosis and recommendation integrated system (DRIS) and the site-specific nutrient management (SSNM) is potent. DRIS can show which fertilizers should be used to achieve the optimum yield of a crop, while SSMN can balance and determine which nutrients that crop needs and the nutrients providing the capacity of the local soil.