A participatory approach was used to improve smallholder tomato farmers’ understanding of and access to soil health monitoring in the Morogoro Region of Tanzania. Baseline soil characteristics were gathered from 50 tomato fields in the region, local soil knowledge was elicited from farmers and used to develop a soil health card to qualitatively assess soil health, and farmers (n = 32) were trained on the use of a low-cost soil test kit to quantitatively assess soil health. Farmers most often described local indicators of soil health in terms of soil texture and tilth, soil color, soil water relations, and soil fertility. Following use of the soil test kit, farmers indicated increased awareness of soil testing services (Wilcoxon signed rank Z = –3.0, P = 0.001), more agreed they had access to soil testing services (Z = –2.7, P = 0.004), and more agreed that soil management recommendations were easy to understand (Z = –3.4, P < 0.0001) compared with pre-exposure results. Farmers continued to use the soil health test kit and soil health card based on a follow-up survey administered 1 year after project completion. Participatory soil health monitoring projects can improve farmers’ ability to monitor and manage soil health, potentially impacting sustained soil and plant health.