Agriculture is crucial to the economic and social wellbeing of the Republic of Cameroon. A national need for increased productivity, farm incomes, food security and rural development requires more effective agricultural extension and advisory systems. The need is persistent. This study analyzed strengths, weaknesses, opportunities, and threats that existed within the current national extension program and examined how form, function, and policy influenced two regions in Cameroon. Analysis focused on 15-year time changes using a comparative case study design. Four regional focus groups and 28 individual interviews bounded 59 cases from four stakeholder groups of farmer leaders, non-governmental organizations, extension representatives, and governmental counterparts. Eighteen primary themes emerged with overlap of opportunities and threats among stakeholders. Incentives to program performance included staff competence and innovative technology transfer. Barriers included infrastructure, postharvest technology, market incentives, financial sustainability, and feedback. A lack of vision for sustainability, inadequate government funding, poor collaboration and linkages, uncoordinated parallel programs, and ineffective management systems reduced program potential. Four themes framed recommendations for improved programs: government investment, trainings, market incentives, and management. Options to improve program sustainability included subsidies that benefit all farmers, more council and private sector engagement with extension, rural infrastructure development, price standardization, and fees for service. Medium and large-scale farmers were willing to pay for extension services when and if available whereas small-scale farmers relied heavily on subsidized services. Accessibility to markets, farm size, and cash crop production are associated with farmers’ acceptance of fees for service. These findings highlighted areas where changes in the nation’s agricultural extension service could improve its relevance in meeting performance targets. Stakeholders’ recommendations for more effective agricultural extension and advisory systems included: 1) providing an autonomous extension service that focuses on specific needs and market opportunities and coordinates all support/parallel programs while collaborating among research and private advisory services; 2) implementing holistic government policies that integrate technology transfer, innovation, health, value-chains, and markets to benefit all farmers; 3) redesigning subsidies that equitability incentivize production and sound environmental practices that benefit all farmers; 4) increasing in-service trainings related to innovations; and 5) updating innovations and harmonizing program activities.