Earth’s water resources are critical for supporting livelihoods and food security but are being
increasingly overexploited to support global agriculture. Diversifying cropping systems could potentially resolve unsustainable water use but trade-offs with other aspects of sustainability and food security have not yet been assessed. We perform a detailed meta-analysis to systematically compare 31 different crop rotations in China– in terms of actual evapotranspiration (ETa), effect on groundwater depth, grain yield, economic output, and water use efficiency (WUE) – and identify configurations that can achieve co-benefits across multiple dimensions. We find that a combination of lowering the cropping index (i.e., harvest frequency), incorporating fallow periods, and introducing higher value crops into the currently dominant winter wheat-summer maize double cropping system can reduce growing season ETa by as much as 31%, mitigate groundwater decline by 19% or more, and increased economic output and economic WUE by more than 11% and 3%, respectively. We also find that multiple diversified wheat-maize–based rotations– all with rotation lengths greater than two years– achieve co-benefits across all evaluated dimensions. This study provides new empirical evidence of the opportunities for diversified crop rotations to balance the multiple objectives of food production, sustainable groundwater use and farmer profitability. Extending this solution to other water-stressed agricultural regions could be an effective strategy in achieving more sustainable food production globally.