Indigenous Knowledge Practices (IKPs) in farming have an effect on household food production and food security. The objective of this study was to investigate IKPs used by smallholder farmers in the production of and access to food and their effects on household food security. The study was conducted in five villages of the Okhahlamba Local Municipality (OLM) under UThukela District of KwaZulu-Natal, South Africa. The villages were selected because their households were engaged in smallholder farming. A mixed method approach was used to collect data. Case studies were used as a preliminary study, followed by a survey questionnaire completed by 100 randomly selected households. The use of IKPs was identified in the whole production system, such as pest management, weeding management, soil fertility management, seed sources, land preparation, storage and processing of the harvest. Households used the IKPs in combination with conventional practices to suite their farming systems. Binary Logit Regression Analysis was used for determining the effects of IKPs on food availability. The results show that traditional pesticides (P<0.01), intercropping (P<0.01) and grain storage in tanks without repellents (10% level) had a significant effect on food availability. Household characteristics such as land size (P<0.05), household size (10% level) and income (P<0.01) also had significant effects on food availability. Household characteristics such as land size, household income and age of the household head were the main determinants of the use of the IKPs in smallholder farming. Even though households used more IKPs compared to conventional practices in their food production systems, overall, the results showed that households prefer conventional practices. Households rated both IKPs and conventional practices as effective in food production. It was concluded that the use of IKPs is not based on access to finances but on farmers’ perceptions of their effectiveness and trust in the local practices. The study recommended that agriculture policies must acknowledge indigenous knowledge practices in smallholder development programmes and specific policy interventions to promote the IKPs must put focus on enhancing socio-economic factors such as land, and assisting farmers in improving practices such as postharvest storage facilities. Identification of a distinctive role of indigenous knowledge farming in light of relatively new concepts such iii as sustainable agriculture, organic agriculture, agroecology, and green economy will be essential in recognizing it role in food production and transitioning South African agriculture to alternative forms of farming in light of climate change mitigation and adaptation policies.