Leucospermum tottum can be propagated by seed or from cuttings. Seed should be sown at the end of February when the nights start to cool off. For best results, always use fresh seed. Soak Leucospermum seed in water to which hydrogen peroxide has been added, at the ratio of 1% of the total volume. This loosens the outer seedcoat and oxygenates the seed. Rub off the softened seedcoat and dust the seed with a systemic fungicide. Sow on a well-drained medium, firm down and cover with a layer of sand in an open seedbed in full sun, or in a seed-tray placed in a sunny position. Germination starts after three to four weeks.

The seedlings will have to be pricked out in batches, as the seed germinates at different times. If the root is very long and has been removed without damaging the root-tip, the root-tip should be pinched off to promote root growth.

Leucospermum tottum can be propagated by cuttings from January to March-April. The cuttings are semi-hardwood, 6-10 cm long and of the current season's growth. The cuttings should be dipped for about four seconds in a rooting hormone solution and placed in a growing house with bottom heat (25ºC) and intermittent mist. The young seedlings or cuttings grow fast and are ready to be planted out after a year. Three years after sowing, the plants will produce their first flowers.

When Leucospermum tottum is planted in the garden, the natural habitat should be kept in mind and the following points are very important for choosing a site: good drainage, a sunny aspect, good air circulation and adequate water. The plants do not like to have their roots disturbed and it is a good idea to put a thick layer of mulch (milled bark, rough compost, leaf litter) around the plant. This will suppress weed growth and keep the soil moist and the roots cool. No manure should be used, although well-matured compost mixed into the soil before planting can be beneficial. The recommended planting distance is 0.65 m and the planting hole should be just slightly larger than the root ball. During the first two years the young plants must be watered regularly. The plants are fairly long lived when planted in a suitable position.

They are very sensitive to the fungal disease Phytophthora cinnamomeum. By the time the disease is noted it is too late to try and save the plant, but otherwise the plants are quite problem free.