The North China Plain (NCP) is a major food producing region in China. Overexploitation of groundwater for irrigation and overapplication of nitrogen (N) fertilizer have contributed to increased food production but have also resulted in water shortages and groundwater contamination. This paper reviews potential conflicts between strategies that ensure water security, food security, and water pollution reduction in the NCP. It outlines some agriculture-related strategies for resolving water shortages. Besides water saving and N saving technologies, policies such as fallow tillage, a water transfer project accounting for the recovery of groundwater level, and N management limiting N input in farmland are discussed. In particular, there are conflicts between the strategies for recovering shallow groundwater and releasing N from the unsaturated zone to the aquifer in the piedmont plain because a large amount of N is stored in the thick unsaturated zone. A transition from food-oriented strategies to sustainable development management of resources and the environment is necessary. To benefit from synergies and avoid tradeoffs between water security, food security, and clean water in the NCP, we must combine water and N management, groundwater level and water quantity control, socioeconomic issues, and climate change.