Soil quality and agricultural sustainability are required to feed about nine billion people by the year 2050. To feed such a population, the planet ought to increase food production by 60%. To attain agricultural sustainability, there should be a balance among biophysical, economic and social dimensions under which soil quality is a core aspect. It is worthwhile to explore soil quality versus agricultural sustainability in sub-Saharan countries because the population is expected to increase by 80%. This chapter reviews the current agronomic practices in countries characterized by semiarid agro-ecological zones and their implications to soil quality and agricultural sustainability, using Tanzania as a case study. We found that agro-pastoralism based on maize, sorghum, millet, sheep, cattle and cow is a current dominant agricultural system but with low yields. Monoculture has contributed to the degradation of soil quality. Drought has raised issues to already stressed ecosystems and made rain-fed agriculture a vulnerable and unsustainable livelihood for smallholder farmers. This situation has reduced the per capita grain harvested area from 0.6 to less than 0.4 ha and thus, affected for more than 70% the smallholder farmers’ livelihoods. Fortunately, areas using fertilizations of animal manure and other organic soil management practices have increased soil fertility and crop yields from 0.82 tn ha−1 under no-fertilization to 1.8 tn ha−1 under organic fertilization.