Organic agriculture is increasingly considered within broader sustainability and health frameworks because agricultural management simultaneously affects soil, plants, animals, ecosystems, food production, and human exposure pathways. This review critically examines organic agriculture through a One Health perspective, integrating evidence from agricultural, environmental, veterinary, microbiological, food-safety, and human-health research. Particular attention is given to soil health and the soil microbiome, environmental functioning, animal health and welfare, antimicrobial use and resistance, food safety and pathogen transmission, and human health implications. The available evidence indicates that organic management can support soil biological functioning, microbial diversity, nutrient cycling, biodiversity, and reduced exposure to certain synthetic pesticides. Organic livestock systems may also provide greater opportunities for species-specific behaviour and lower antimicrobial use. However, these characteristics do not consistently translate into superior outcomes across all health domains. Animal welfare remains strongly influenced by management quality; antimicrobial resistance can persist despite reduced antimicrobial use; and practices such as manure recycling, outdoor access, and crop-livestock integration may create additional pathogen-transmission pathways when inadequately managed. Evidence for human health is strongest for reduced exposure to some pesticides, whereas nutritional differences are generally modest and direct long-term clinical benefits remain insufficiently demonstrated. Overall, organic agriculture should be regarded as a management framework with the potential to contribute to One Health objectives rather than as an inherently healthier production system, with outcomes depending strongly on specific practices and environmental conditions.
