Aloe suprafoliata is easily propagatedby seeds or suckers.

Sow seeds in trays filled with a mixture of coarse river sand, compost and soil. Spread the seeds evenly over the surface and lightly cover with a layer of small pebbles, this helps keep the seedlings upright and lessens the risk of damping off. Fresh seeds germinate quickly at 18°C. Place the seed tray in a dry well-ventilated area, keep the soil moist, do not allow it to dry out, but also do not let it get too wet as the seedlings may damp off if overwatered. The seedlings can be transplanted after one year.

Offshoots around the main rosette can be divided and cuttings should be dried for a week before planting in river sand or well-drained potting soil and kept warm.

In containers, Aloe suprafoliata plants are generally slow-growing and don't require frequent repotting. Plants that are toppling over in their pots or are exhibiting a lack of growth, should be repotted . A fast-draining potting mix with one-third sand or pebbles is recommended. When dealing with larger plants, it is important to carefully separate the root ball. In cases where certain varieties produce offsets, it is advisable to pot them individually.

Aloe suprafoliata should be fertilized with a low-nitrogen fertilizer formulated for cacti and succulents, diluted to half the recommended strength, once or twice during the growing season.

In the garden, this plant thrives in sunny locations, in well-drained soil, with minimal water. It is well-suited for outdoor cultivation in mild climates for landscaping purposes and can also be grown in rocky, well-drained soil in drier regions. It adapts to various soil types (as long as the soil is well-drained) and climates, but flourishes in temperate regions that are not excessively cold or wet. The plant will also thrive in partial shade but will be healthier and flower better in full sun.

Aloe suprafoliata is highly drought-resistant, but for a healthy, floriferous plant, it should be watered moderately to generously in summer, but be careful not to overdo it. During the cold winter months, it is best to refrain from watering altogether. To maintain the plump appearance of the leaves, it is advisable to provide supplemental watering in summer if the rainfall is insufficient. Although it can withstand long periods of drought outdoors, it will thrive and produce more flowers if watered in spring and summer. On the other hand if watered only occasionally, then the the red colouration of the leaves will intensify.

Aloe suprafoliata will tolerate light frost but is susceptible to damage in hard freezes. Also, cool winter temperatures (around 5-10°C) will encourage flower development.

As with all succulents, avoid letting Aloe suprafoliata sit in stagnant water and refrain from overwatering, ensuring no water collects in the rosettes.

Incorrect watering, poor drainage, or too much shade can lead to rotting and infestations of pests and other diseases.