This paper is the results of a Soil Fertility Management (SFM)survey conducted in 1999 to determine the status and trendsin soil fertility management and associated soil conditions inBhutan in the face socio-economic development of the lastfour decades. While the traditional SFM systems based on theuse of animal manures still dominate, the ability to maintainand sustain these indigenous systems is being underminedby socio-economic factors. Households have been increasinglydepending on fertilizer, especially urea, to increase soilfertility and maintain crop yields, and this trend is predictedto continue. Generally, soil nutrient status is poor. The majorconcerns are a low pH and nitrogen, phosphate status andimbalanced base nutrition. Since sustainable development isa key government development objective, the survey resultswere examined to determine the sustainability of existingSFM practices and soil use for crop production. In mostsituations sustainability is being maintained, but theassessment of SFM and crop production questionssustainability in some areas. Lack of sustainability is aconcern on both wetland and dryland soils and amonghouseholds identified as being less able to manage soilfertility. This paper has identified implications for policy,research and extension.