<p>Soil and water conservation (SWC) practices are critical for sustainable agriculture in erosion-prone regions like the Central Ethiopia Region, Alicho District, yet their long-term viability remains unknown. This study assessed farmers’ perception of the sustainability of SWC measures through household surveys (<i>n</i> = 355), field observations, and ordered logit analysis. Findings reveal only 27.3% of existing SWC practices are fully functional, while 50.7% are partially damaged and 22% are non-operational or were never adopted. About 55.8% of farmers rated controlled grazing as moderately sustainable and mulch application (54.1%) as most effective, whereas check dams (63.1%) slightly sustainable and tree planting (22.3%) faced skepticism due to design mismatches and slow returns. Regression identified education level (<i>p</i> = 0.01), farm size (<i>p</i> = 0.008), and institutional support (extension services (<i>p</i> = 0.008)) as key sustainability drivers, while steep slopes (<i>p</i> = 0.046) and uncontrolled grazing (<i>p</i> = 0.012) were significant barriers. The farmers observed that about 36.8% of damage was deliberate, primarily due to oxen plowing interference (44.6%) and land productivity concerns (31.3%), underscoring farmer-resource conflicts. The study highlights a critical “maintenance gap,” with over half of SWC structures deteriorating post-implementation due to inadequate follow-ups. To address the observed sustainability challenges, we recommend participatory redesign of SWC structures and community-based maintenance complemented by targeted extension services and economic incentives. A shift to lifecycle-based conservation is needed, integrating technical adaptations into challenging environments while balancing livelihoods and ecological benefits.</p>