Management systems impact on soil health is important to evaluate ecosystem services. A field study was established at Piketon, Ohio to determine the long-term effects (2005 to 2013) of tillage and cover crops on soil health. Treatments included corn-soybean rotation with conventional tillage (CT-CS), corn-soybean rotation with continuous no-till (NT-CS), and corn-soybean-wheat-cover crop rotation with continuous no-till (NT-CSW-CC) and replicated three times. Composite soil samples were collected from 0 to 90 cm depth at 15 cm increments, processed and analyzed for microbial biomass, earthworms, biological activity, total, active and particulate organic C and N, pH and buffering capacity, bulk density and porosity, water infiltration, and color. Results showed that NT with and/or without cover crops significantly increased microbial biomass, earthworms, biological activity, total, active and particulate organic C and N, buffering capacity, porosity, aggregate stability and water infiltration and decreased bulk density as compared with CT-CS. The NT-CSW-CC had more pronounced effects on soil health properties than on NT-CS. Field-moist soil color under CT-CS has changed from 10YR6.3 to10YR5.8 under NT-CS and 10YR5.6 under NT-CSW-CC. Irrespective of treatments, soil health properties decreased except earthworms and bulk density with depth. Normalizing all the values of soil properties to calculate soil health indices, the results showed that soil health improved more under continuous NT-CSW-CC than in NT-CS and CT-CS, respectively.