Aloe khamiesensis is best grown from seed. Seed must be sown as fresh as possible. When kept too long they are parasitised by small crawling insects. The best time for sowing would be in the summer from January onwards. Use coarse river sand and cover seeds lightly, then keep moist. It is advisable to treat seeds with a long-lasting fungicide, as seedlings are prone to damping off, a fungus that eventually kills the young plants. Simply shake seeds in a container with some fungicide. After germination, when plants are about 2-3 cm high, plant over, using a sandy-loam medium and feed with organic based fertilizer at least once a month to ensure healthy growth. If you have a garden with clay soil, use some agricultural lime and bone meal to break up and nourish the soil.

Mature plants in cultivation may at times be subjected to attack from scale and aphids. For scale an oil-based solution can be used; even soap water has proven effective against scale. Contact insecticides for insects usually work well but in heavy infestations a systemic application may be necessary. All known garden pests can be kept to a minimum by simply ensuring optimal growing conditions and healthy plants.

Companion plants to Aloe khamiesenis include A. pearsonii, A. claviflora, A. falcata, A. gariepensis, A. dichotoma, A. dichotoma subsp. ramosissima and A. arenicola. Other additions to consider include are Lampranthus multiradiatus, L. aureus, Pelargonium echinatum, P. xerophyton, P. spinosum, P. sericifolium, P. crithmifolium, Tripteris oppositifolium, Stoeberia arborescens, Gazania krebsiana, Hermannia saccifera, Lampranthus reptans and Oscularia deltoides. Larger succulents like Tylecodon paniculatus, Cyphostemma juttae and Cotyedon orbiculata are also fantastic choices.