Soil is fundamental to life on Earth through the provision of many ecosystem services. The current model of economic development exerts significant pressure on this resource, leading to degradation processes that are accelerated by the effects of climate change. This situation hinders the achievement of the UN Sustainable Development Goals, and some parts of the world have started a process to reverse this trend, among them the European Union, which has chosen the living labs approach as a strategic solution. The growing interest in this subject within the EU has led to the establishment of a new framework to design and test sustainable policies to improve soil health and management at the continental scale. This review presents State-of-the-Art information on the use of the living labs approach to improve soil health. It also introduces the SOILL Support Structure for Soil Health Living Labs (SHLLs) and Lighthouses and the significant role of the SOILL-Startup project to help establish a network of 100 such structures across the EU. Following the PRISMA methodology, the review describes the main features of SHLLs (definition, types of stakeholders, field and scale of application), as well as their current geographical distribution. The work provides information that can be used by the scientific community, policy makers, and soil stakeholders who prioritise soil health, regardless of the context in which they operate.