Fatigue remains a significant hazard in commercial aviation and has been a major concern among all stakeholders for decades. This review of the literature explores the current prescriptive structure of the regulatory environment (Part 117) and its effect on fatigue management. To illustrate the impact of fatigue on flight operations, this article includes a brief analysis of two National Transportation Safety Board (NTSB) accident reports where fatigue was indicated as a factor. Current research in fatigue management and efforts by the Federal Aviation Administration point to the benefits of using a Safety Management Systems (SMS) methodology to manage fatigue. Using the framework of an organization’s functioning SMS, various solutions are discussed, including using existing reporting systems to gather data and the development of potential performance indicators, with an emphasis on the need for research into commuting habits of flight crews and establishing a safety culture based upon fitness for duty.