Water thoroughly when the soil is completely dry. Reduce watering significantly during the winter dormancy period to prevent root rot. Ensure excellent drainage to avoid waterlogging.

Pruning is generally not required for Coleocephalocereus buxbaumianus. If necessary, remove dead or damaged parts with a clean, sharp tool. This is typically done to maintain shape or remove unhealthy growth.

Propagation is best achieved through seed. Sow seeds in a well-draining sterile mix and keep warm and lightly moist. Cuttings are possible but can be prone to rot and are less successful than seed propagation.

Repot young plants annually or when root-bound. Mature plants can be repotted every 2-3 years. Use a gritty, fast-draining potting mix and a pot with drainage holes, preferably terracotta.