The water elder is not common in cultivation, but it is useful for planting alongside water in the garden. It will also tolerate normal garden conditions, although the stature of the tree will be determined by the amount of water it gets. It is reasonably hardy to frost and is a fast grower under optimal conditions. Nuxia oppositifolia is a valuable asset to a bird garden as it attracts insects, which in turn attract insectivorous birds. It can also be grown in a container and forms an attractive pot specimen. Not much information is available about this plant, but it is likely that it will respond well to pruning and can be used as part of a mixed screen or as a clipped hedge.

Propagate from semi-hardwood cuttings using rooting hormone. Seed will possibly be difficult to obtain but it should be sown in seed trays on a fine seedling mix. Cover lightly and do not allow to dry out. Avoid overhead watering as the seed is fine and will wash away. Instead place the tray in a clean, shallow container of water and allow the water to soak in to the tray from below. Once the surface is wet, remove the tray from the water. Transplant the seedlings once they have formed their true leaves.