Water sparingly during the growing season (spring and summer), allowing the soil to dry out completely between waterings. Reduce watering significantly in autumn and cease entirely during the winter dormancy period to prevent root rot.

Pruning is generally not required for Pleiospilos nelii. Remove any dead or dried leaves at the base of the plant to maintain cleanliness and prevent potential pest issues. Avoid cutting into healthy leaf tissue.

Propagation is primarily done through offsets or 'pups' that form at the base of the parent plant. Gently separate these offsets when they are large enough to handle and allow them to callus for a few days before potting in well-draining soil.

Repot Pleiospilos nelii every 2-3 years, or when the plant outgrows its current container. This is best done in spring before active growth begins.

Use a very gritty, well-draining potting mix and a pot with drainage holes.