African agriculture stands at a crossroads. Either food security in Africa will remain elusive with isolated successes fuelling a sense of false optimism in an otherwise dismal situation, or decisive action can be taken to assist small-scale farmers to grow more and more valuable crops. Excellent progress is being made in crop improvement and seed systems, and many crop diseases, particularly viruses and fungal leaf pathogens, no longer pose a major problem. Low soil fertility and nutrient depletion continue, however, to represent huge obstacles to securing needed harvests. Improving access to fertilisers is a necessary countermeasure; however, the low returns from unskilled use of these products present a major impediment to their adoption by most small-scale farmers. Integrated Soil Fertility Management (ISFM) is defined as: the application of soil fertility management practices, and the knowledge to adapt these to local conditions, which optimise fertiliser and organic resource-use efficiency and crop productivity. ISFM represents a means to overcome this dilemma by offering farmers better returns for investment in fertiliser through its combination with indigenous agro-minerals and available organic resources. Disseminating knowledge of ISFM and developing incentives for its adoption now stand as challenges before national planners and rural development specialists. Done efficiently, these will result in more productive and sustainable agriculture, improved household and regional food security and increased incomes among small-scale farmers.