Several studies have reported agronomic benefits by improving soil health/quality, but uncertain knowledge remains when determining specific impacts on water quality off-field. This study investigated the links between runoff water quality and soil health/quality in agricultural fields of the Mississippi delta under three land management scenarios: Conservation Reserve Program (CRP), vegetative buffer (VB), and row crops (RC). Using the Soil Management Assessment Framework (SMAF), a Soil Quality Index (SQI) was obtained based on ten soil health/quality indicators from 2008 and 2012 datasets. The SMAF identified significant differences in soil health/quality improvements among scenarios over a four-year period. Varied relationships between water quality parameters, SQI, and soil health/quality indicators were determined. Individually, physical and chemical soil indicators were also correlated with runoff water quality. Overall, the evidenced relationship between soil health/quality and water quality parameters was stronger in areas under CRP.