Background and aims <p>The main objective of this three-year study was to investigate how tillage to perennial inter-row cover crop soil management affects the soil moisture regime and plant health in an organic vineyard.</p> Methods <p>We had two vineyard treatments, where we studied the annual changes of (1) shallow tillage soil management during the first study year to perennial cover crops by the third year (CC), and (2) a permanent grass cover inter-row management (GR) site. Measurement points were chosen at upper, middle, and lower portions of the study slopes with ~ 8% incline. Soil water content (SWC), and vineyard plant growth and health based on the Normalized Difference Vegetation Index (NDVI), Photochemical Reflectance Index (PRI), the fraction of absorbed Photosynthetically Active Radiation (fAPAR), and Leaf Area Index (LAI) were monitored.</p> Results <p>Our results showed distinct differences among the studied inter-row managed sites and among monitoring points. The CC site had significantly (<i>p</i> &lt; 0.05) higher average SWC at both 15 and 40&#xa0;cm depths compared to the GR site. Soil heterogeneity had a significant influence on NDVI, PRI, and fAPAR (<i>p</i> &lt; 0.001). The LAI was significantly higher at the CC grapevine compared to GR (<i>p</i> &lt; 0.01). Plant parameters showed moderate relationships with specific soil parameters (total N, pH, or SWC). Continuous cover crop inter-row management significantly reduced the SWC for the upper soil layers (i.e. third year), however, for plant development it showed to be beneficial.</p> Conclusion <p>Overall, cover crop inter-row management might be a good option in vineyard areas provided that prolonged drought is scarce.</p>