Uganda’s agricultural extension system has experienced several changes since colonial times. Despite wellintended interventions in extension reforms, a large number of smallholder farmers and other vulnerable groups remain unreached by the various public extension systems, and the private sector plays only a limited role. Numerous organisational performance issues and changing institutional mandates—for example, in the National Agricultural Advisory Services (NAADS)—have hindered the effectiveness and efficiency of the public extension system. These problems include inadequate extension staff, corruption, inadequate funding from the central government, the small number of private-public partnerships, and a continued top-down linear focus on extension, as has been suggested by the new reform of the Single Spine extension service system. This paper presents a critical review of the historical and current state of agricultural extension reforms in Uganda based on the Medium Term Expenditure Framework Fiscal Year data for the agricultural sector, the 2014 ATAAS baseline survey dataset and key informant interviews in Kampala. It identifies not only opportunities and challenges but also key policy options for further refining the implementation and effective rollout of Uganda’s Single Spine extension system.