Water sparingly, allowing the soil to dry out completely between waterings. Overwatering is the most common cause of root rot. During the winter dormancy, reduce watering significantly or cease altogether.

Pruning is generally not required for Echinocactus horizonthalonius. If a stem or fruit needs removal due to damage or disease, use a clean, sharp knife and allow the wound to callus over before watering.

Propagation is typically done through seed. Sow seeds in a well-draining cactus mix and keep warm and slightly moist. Cuttings are not usually successful due to the plant's growth habit.

Repot every 2-3 years or when the plant outgrows its container. Use a gritty, fast-draining cactus potting mix. Repot in the spring before the active growing season begins.