There is an estimated 345 million people facing food insecurity in 2023, more than double the number in 2020. Increasing mineral fertilizer prices and longstanding problems with inefficient fertilizer use have contributed to this growing problem. In response to this challenge, this report explores supplementary and alternative products that offer the potential to reduce reliance on mineral fertilizers, as well as solutions for improving fertilizer use efficiency. Improved efficiency leads to reduced greenhouse gas emissions, amongst other benefits. Adopting these products and practices on a large scale, within an integrated approach to long-term soil health, has the potential to enhance food security, improve smallholder yields and livelihoods, and mitigate climate and environmental impacts. This report aims to do the following: Provide a snapshot of current approaches to fertilizer use in Sub-Saharan Africa and South Asia, exploring the problems associated with overuse and underuse of mineral fertilizers. Introduce a set of alternative and supplementary products, as well as technologies and business models that offer the potential to improve fertilizer use efficiencies. Identify opportunities for, and bottlenecks to, large-scale adoption of alternative fertilizer strategies, highlighting the role that governments, investors, donors, and private firms can play in accelerating progress in this space. Showcase eight case studies from Africa and South Asia of companies working on fertilizer alternatives and solutions to promote more efficient fertilizer use. Three of these companies have been supported by the Commercial Agriculture for Smallholders and Agribusiness Technical Assistance Facility (CASA TAF).