Leucospermum patersonii is quite easy to propagate from seed or cuttings. Sow seed in late summer to autumn (March-May). Use a well-drained medium, e.g. one of two parts coarse sand to one part leaf mould and one part loam. Cover the seeds with coarse, clean sand or milled bark and keep warm and moist. Seeds need alternating cold night and warm day temperatures to initiate germination, 4-10°C and 15-20°C, typical of autumn in the Western Cape. Germination can be induced if the seeds are soaked in a 1% solution of hydrogen peroxide for 24 hours. This oxygenates the seed and softens and loosens the seed coat, which should be rubbed off. Watering the seed tray with a fungicide will help prevent fungal disease. Germination takes 1 to 2 months and the young seedlings are ready to be potted up as soon as they have developed their first set of true leaves.

Vegetative propagation requires taking semi-hardwood tip or heel cuttings from the current season's growth from late summer to autumn (March-May). Treat with rooting hormone and place in a well-drained medium under mist with a bottom heat of about 24°C. Cuttings without bottom heat will take longer to root. Good air circulation is required to prevent fungal infection.

This species requires a sunny position with free air circulation, well-drained soil and no rich manure or strong fertilizers. Although Leucospermum patersonii is alkaline-loving it grows equally well in acidic soils. Well-rotted compost applied as mulch in autumn and in spring will supply the low levels of nutrient required. Slow-release or low doses of fertilizer can be used, but avoid fertilizers with a high phosphorus (P) content.

This species could be a wonderful specimen shrub for medium to large gardens, but although it grows vigorously it also dies easily. It is probably susceptible to root fungi such as Phytophthora and any root disturbance. It is recommended that it be planted in a spot in the garden where it can be left undisturbed.

Grafting onto a hardier rootstock is recommended to overcome its susceptibility to root disease. Leucospermum conocarpodendron is the species recommended for providing the hardy rootstock.

Grafting leucospermums: The technique is simple and the same as for Mimetes and Orothamnus. There are a number of different types of grafts, but the preferred one is called the cleft graft because it provides a strong union between the rootstock and the top part of the plant called the scion. The cleft graft involves choosing a healthy rootstock with a stem approximately 15 mm in diameter and the wood still green. A fresh young shoot is selected from the plant to be grafted. The shoot should be either the same diameter as the rootstock or may be a bit thinner.

Equipment required are sharp clean scalpels, grafting or budding tape (plastic), and a broad-spectrum fungicide and wax or tree sealer. The top of the rootstock plant is removed with one clean cut. A single sharp vertical incision, about 30 mm deep is made into the top of the cut surface of the rootstock. The cut surfaces are washed with fungicide. A fresh, sturdy shoot approximately 60-100 mm long is cut from the leucospermum plant and the basal leaves are removed. The stem is pared on either side with single clean slices producing a tapering wedge. This is inserted into the vertical cut and firmly bound in position using the tape. Tree sealer or wax is used to seal the cracks at the union to prevent water from penetrating the graft and causing disease. A clear plastic bag is placed over the graft to keep the humidity levels higher and prevent desiccation. Hoops of wire support the plastic bag. The plant is then placed in a protected position out of direct sunlight. The area should not be too warm, but the light conditions must be good.

The grafts must be closely monitored over the next few weeks. The union between the rootstock and scion will take a number of weeks, but a successful graft should be evident in three months. The plastic is slit and slowly removed to allow the graft to adapt to its surroundings.

It is important that the rootstock is chosen from a disease-resistant species and also that it assumes the same proportions as the plant to be grafted onto it. If a large protea such as Leucospermum patersonii is grafted onto a smaller species such as Leucospermum cordifolium it will outgrow the rootstock in diameter at the union, become too heavy, and the top part of the plant will fall over.