Purpose: There is inconsistency in the design, understanding, implementation and monitoring of soil health programmes. Despite mounting scientific evidence for the credibility of certain soil health indicators, an increase in the reporting of programme benefits, and progress in communicating these benefits, many farmers remain hesitant to implement structured management plans and strategies tailored to address soil health. The purpose of this research is to investigate the proportion of Lachlan and Macquarie Valley landholders who implement a structured soil health programme and to better understand the role of extension in the management of these. Design: Non-parametric analysis of a mail-based survey supported with content analysis of landholder comments was used. Findings: Results suggests that the overall landholder attitude towards soil health management is positive, although soil health management programmes are often inconsistent, unstructured, or ad hoc. Ongoing communication between landholders, agronomists, extension agencies and scientists is shown to be vital in the adoption of soil health management programmes. Practical implication: By understanding landholder attitudes and management practices, as well as the role of extension, extension efforts can become more targeted and effective. Value: This article shows that soil health management is a primary focus of Australian farmers and elucidates the importance of extension efforts in management and planning. Areas where extension should be focussed are identified.