This research article was published by MDPI, 2021Soil organic carbon (SOC) is widely recognised as pivotal in soil function, exerting important controls on soil structure, moisture retention, nutrient cycling and biodiversity, which in turn underpins a range of provisioning, supporting and regulatory ecosystem services. SOC stocks in sub-Saharan Africa (SSA) are threatened by changes in land practice and climatic factors, which destabilises the soil system and resilience to continued climate change. Here, we provide a review of the role of SOC in overall soil health and the challenges and opportunities associated with maintaining and building SOC stocks in SSA. As an exemplar national case, we focus on Tanzania where we provide context under research for the “Jali Ardhi” (Care for the Land) Project. The review details (i) the role of SOC in soil systems; (ii) sustainable land management (SLM) techniques for maintaining and building SOC; (iii) barriers (environmental, economic and social) to SLM implementation; and (iv) opportunities for overcoming barriers to SLM adoption. We provide evidence for the importance of site-specific characterisation of the biophysicochemical and socio-economic context for effective climate adaptation. In particular, we highlight the importance of SOC pools for soil function and the need for practitioners to consider the type of biomass returns to the soil to achieve healthy, balanced systems. In line with the need for local-scale site characterisation we discuss the use of established survey protocols alongside opportunities to complement these with recent technologies, such as rapid in situ scanning tools and aerial surveys. We discuss how these tools can be used to improve soil health assessments and develop critical understanding of landscape connectivity and the management of shared resources under co-design strategies