Mass drug administration (MDA) of ivermectin is currently the main strategy to achieve elimination of onchocerciasis transmission (EoT). Modelling suggests that EoT may not be reached in all endemic foci using annual MDA alone. Onchocerciasis and loiasis are co endemic in forest areas of Central Africa, where ivermectin treatment can lead to severe adverse events in individuals with heavy loiasis load, rendering MDA inappropriate. Vector control has been proposed as a complementary intervention strategy. Here, we discuss: (i) achievements and pitfalls of previous interventions; (ii) epidemiological impact, feasibility and combination with MDA to accelerate and/or protect EoT; (iii) role of modelling; (iv) opportunities for innovative methods of vector monitoring and control, and (v) strengthening entomological capacity in endemic countries.