This paper explores the potential implementation of Nature-Based Solutions (NBSs) in agriculture, specifically focusing on soil and water management in Southern Italy, particularly in the Apulia and Basilicata regions. Through a tailored questionnaire, it investigates farmers' perceptions of the utility of NBSs, addressing key issues in the region and evaluating their role in addressing soil and water management challenges. Findings reveal primary challenges such as drought, floods, and water pollution, with soil erosion being a major concern. Several NBSs, including wetlands and bioswales, demonstrate consistent utility and performance, while disparities exist for agroforestry and strip cropping. The study underscores a significant gap in the economic valuation of NBSs, emphasizing the need for comprehensive assessments that incorporate livability improvements, water quality enhancement, and socio-cultural benefits. Additionally, an analysis of NBS implementation across Italian agriculture reveals limited case studies, suggesting the need for strategic expansions to meet Sustainable Development Goals. This research offers critical insights into the effectiveness and challenges of NBSs in agricultural soil and water management, advocating for enhanced stakeholder engagement and the development of multidimensional evaluation frameworks to support sustainable practices.