Oil palm cultivation occupies a large planting area in Malaysia and is one of the most profitable commercial crops contributing to unprecedented socio-economic development in the country. The crop, however, requires high uptake of macronutrients and some relevant amounts of micronutrients largely supplied by agrochemical-based fertilisers. The overuse of fertilisers endangers the ecosystem with possible effect on the environment especially on the soil health and its microbial diversity. With oil palm replanting in its fourth generation, the practice needs to be sustainable yet economic without compromising the yield and this is the challenge being faced by the industry. This article discusses the importance of fertilisers, types of fertilisers (inorganic, organic and microbial-based products) and balancing the effects with agrochemicalbased fertilisers in oil palm plantations through balanced integrated fertiliser application. This could be one of the most effective sustainable strategies in improving the soil health by enhancing the biodiversity of microorganisms and community composition in soil towards a balanced ecosystem. Sustainable soil health management system has the capacity to produce higher yields while maintaining if not improving the soil health. Finally, the article addresses future recommendations that highlight soil health which is also the current focus of modern agriculture.