Hill horticulture faces numerous constraints, including soil erosion, landslides, water scarcity, unique cropping seasons and limited access to extension services and technologies. The Nilgiris, labelled as the "Organic District of Tamil Nadu," serves as an ideal setting to assess farmers’ awareness, adoption and challenges related to Sustainable Horticultural Practices (SHP). This study focused on 320 farmers across four blocks: Coonoor, Ooty, Gudalur and Kothagiri, with an emphasis on hill-top vegetables such as potato, carrot, cabbage and cauliflower. The findings present a mixed scenario. While most farmers were aware of SHP, only 55.00 % adopted erosion control measures and 60.63 % practiced integrated pest, disease, nutrient and irrigation management. Some practices, such as improved filtration runoff (69.37 %) and animal waste management (66.25 %), were more widely adopted. However, significant challenges were noted, including limited time to track market trends for hill vegetables (68.00 %) and high transportation costs (67.00 %). The leading source of contamination was wild animal intrusion (94.38 %), followed by improper animal waste decomposition (81.56 %). Workers’ hygiene was identified as a contamination risk by 73.13 % of respondents, while transport containers and biosecurity breaches were reported by 65.63 % and 64.69 %, respectively. This study underscores the necessity to promote SHP adoption to address these numerous constraints. Enhancing farmers’ knowledge and practices can significantly improve horticultural sustainability and foster development in the hilly regions.