Brachystelmas are prone to root rot, aphids, red spider mite and fungal infections.

Like most brachystelmas, a well-drained, gritty soil should be used. The long, fleshy roots should be planted below the soil and the pot filled with grit. Unlike other brachystelmas that have rounded tubers, this species has clusters (fascicles) of fleshy roots.

Brachystelma gerrardii comes from the summer-rainfall region – the plants thus need water during summer and should be kept dry during the winter. Attentive watering is needed as you should allow the soil to dry out between waterings; this is between 9 to 14 days.

If the plant is growing in the summer-rainfall region, it is best to keep them in a dry spot where they can receive rainwater, with hardly any additional watering on your part. If not, watering should begin once the seasonal growth begins, and stop when the plant becomes dormant, the leaves turn yellow and can fall off. This species is found in open grasslands and should receive a lot of sun and be in a position that allows free air circulation.

According to Alison Young, a horticulturist at the University of KwaZulu-Natal, who has successfully grown Brachystelma gerrardii from seed, germination takes some months. The species is very slow growing and only flowered in the fourth year. Alison recommends an acidic compost and a slow-release fertilizer. Avoid keeping the soil medium damp, because the plant is susceptible to fungal infections and the roots rotting.