Tillage and cropping systems can strongly influence soil health and soil organic carbon (SOC). We carried out an integrative study on the effects of permanent shifting from no-tillage (NT) to reduced tillage (RT) and crop rotation on soil health indicators, soil organic carbon (SOC) fractions and stocks, and soil health index (SHI) in a semi-arid Mediterranean environment. A rainfed field experiment including 12-year continuous NT ("NT12") and 7-year NT converted to 5-year RT ("NT7RT5", i.e., tillage reversal), both combined with three wheat-based diversified crop rotations (DCRs), was conducted. A 12-year continuous conventional tillage ("CT12") system under wheat monoculture served as a reference. Soil samples were collected at 0-7.5, 7.5-15, and 15-30 cm depths. SOC fractions included particulate organic carbon (POC) and mineral-associated organic carbon (MAOC). Compared to continuous NT (i.e., NT12), tillage reversal from NT to RT (i.e., NT7RT5) did not affect the contents of SOC and its fractions and SOC stocks at 0-30 cm but modified the vertical distribution of SOC and its fractions, with NT7RT5 having lower contents of SOC (1.74 %) and POC (0.65 %) at 0-7.5 cm but greater contents of SOC (1.68 %) and MAOC (1.05 %) at 7.5-15 cm and higher POC content (0.70 %) at 15-30 cm; NT7RT5 lowered the available water capacity (-18 %) and increased total nitrogen (+8 %) at 0-30 cm; but SHI values at 0-30 cm were comparable between NT12 (0.5) and NT7RT5 (0.54). Under NT12 and NT7RT5, crop rotation influenced total nitrogen, cation exchange capacity, bulk density, and total porosity, with "Rotation 3", including wheat, pea, triticale, and faba bean, showing the best results. Despite having higher nutrient (N-P-K) inputs, CT12 resulted in lower SOC content (1.16 %) and stock (45.2 Mg C ha-1) and POC content (0.31 %) at 0-30 cm compared to the cropping systems in NT12 and NT7RT5. These results: i) provide evidence on the possibility of shifting from long-term NT to RT without harming, in the short term, the overall soil health status and SOC storage in the topsoil (0-30 cm), but with the risk of reducing water retention in the soil, which may penalize crop productivity; ii) suggest that Rotation 3 could be recommended in the study region and similar Mediterranean areas for improving certain soil health attributes; and iii) confirm the soil and carbon benefits of conservation tillage (NT, RT) coupled with DCRs.