Lucerne (alfalfa, Medicago sativa L.) is a forage legume that is widely cultivated in arid and semi-arid regions of the world. The main aim of this review was to highlight the effects of salt stress on the performance of lucerne and to suggest different tolerance mechanisms and management strategies for improving its yield under salt stress. Salt stress significantly affects seed germination, carbon fixation, light harvesting, biological N2 fixation, mineral uptake and assimilation and dry-matter accumulation in lucerne. Accumulation of osmolytes or compatible solutes such as proline, polyamines, trehalose and soluble sugars confers salt tolerance in lucerne. Maintenance of low Na+: K+ ratios, antioxidant enzyme activation, and hormonal regulation also help lucerne to withstand salt stress. The screening of diverse genotypes on the basis of germination indices, gas exchange, biomass production, lipid peroxidation and antioxidant enzymes might be useful for breeding salt-tolerant lucerne genotypes. Novel biotechnological tools and functional genomics used to identify salt-conferring genes and quantitative trait loci will help to improve salt tolerance. Use of rhizobial and non-rhizobial plant growth-promoting bacteria, arbuscular mycorrhizal fungi, exogenous application of osmoprotectants, and seed priming with brassinolide, gibberellic acid and salicylic acid may help to improve lucerne performance in saline environments.