Organ donation in South Africa is limited, leading to organ shortages. This scoping review collates recommendations addressing culture and religion as organ donation barriers. Culture and religion are cited barriers to organ donor registration and may explain individuals’ desire to donate but reluctance to register as a donor. Studies focusing on South Africans offering culturally and religiously relevant strategies were included. Experimental, observational, qualitative and review studies about organ donation in South Africa were included. Non-scientific sources were excluded. Scopus, SciELO, PubMED, Sabinet, Google and Google Scholar were searched up to January 2026. 28 articles (1990 to 2022) were selected. Thematic analysis identified recommendations and recurring themes. Recommendations varied by religion: ancestral appeasement for African communities, mosque-based education for Muslims, biblical emphasis for Christians and karma/generosity for Hindus and Buddhists. Themes included family-centred approaches, education on brain death, engaging religious leaders and integrating donation into school curricula. Donation education in schools can foster generational attitude shifts.