Increasing fertilizer access and use is an essential component for improving crop production and food security in sub-Saharan Africa (SSA). However, given the heterogeneous nature of smallholder farms, fertilizer application needs to be tailored to specific farming conditions to increase yield, profitability, and nutrient use efficiency. The site-specific nutrient management (SSNM) approach initially developed in the 1990 s for generating field-specific fertilizer recommendations for rice in Asia, has also been introduced to rice, maize and cassava cropping systems in SSA. The SSNM approach has been shown to increase yield, profitability, and nutrient use efficiency. Yield gains of rice and maize with SSNM in SSA were on average 24% and 69% when compared to the farmer practice, respectively, or 11% and 4% when compared to local blanket fertilizer recommendations. However, there is need for more extensive field evaluation to quantify the broader benefits of the SSNM approach in diverse farming systems and environments. Especially for rice, the SSNM approach should be expanded to rainfed systems, which are dominant in SSA and further developed to take into account soil texture and soil water availability. Digital decision support tools such as RiceAdvice and Nutrient Expert can enable wider dissemination of locally relevant SSNM recommendations to reach large numbers of farmers at scale. One of the major limitations of the currently available SSNM decision support tools is the requirement of acquiring a significant amount of farm-specific information needed to formulate SSNM recommendations. The scaling potential of SSNM will be greatly enhanced by integration with other agronomic advisory platforms and seamless integration of digital soil, climate and crop information to improve predictions of SSNM recommendations with reduced need for on-farm data collection. Uncertainty should also be included in future solutions, primarily to also better account for varying prices and economic outcomes. •The SSNM approach was adapted for rice, maize and cassava production systems in SSA.•The SSNM approach increased yield, profitability, and nutrient use efficiency.•SSNM had 24% and 69% higher yield than the farmer practice for rice and maize.•Rice and maize yields were 11% and 4% higher in SSNM than local recommendations.•Integration with other digital platforms and databases can improve SSNM tools.