Integrated Soil Fertility Management (ISFM) refers to a holistic approach to managing soil fertility that combines a variety of techniques and practices to improve soil health and enhance agricultural productivity, particularly in smallholder farming systems. Despite the associated higher labor and other input demands associated with ISFM adoption, there is limited empirical evidence regarding the positive outcomes of these investments at the household level. Using data from 380 tomato farmers in three regions of Ghana, we explore the relationship between ISFM adoption and household welfare. The methodology employed relies on inverse probability weighting regression adjustment (IPWRA). The findings reveal that ISFM adoption positively impacts household welfare by increasing net income by GH₵436.88 ($60.43)/ha, improving household assets by GH₵518.17 ($71.67)/ha, enhancing food security by 1.23 points, and reducing household expenditure by GH₵57.39 ($7.94)/ha. The results highlight ISFM’s potential to enhance smallholder welfare through increased income, improved household assets, and better food security, contributing to poverty reduction and sustainable agricultural development. Policies should focus on improving access to fertilizers, seeds, and pesticides, coupled with extension services and farmer education programs to promote ISFM adoption. Tailored interventions targeting older and more experienced farmers, as well as household heads, are essential to overcome barriers to adoption and maximize the economic and welfare benefits of ISFM practices.