Quinoa is a strategic crop due to its high N content and its adaptability to adverse conditions, where most of the soils are deficient of nitrogen (N). The central question in this review was the following: How can quinoa yield low levels of nitrogen in the soils of Altiplano? This question was unraveled based on different factors: (1) fertilization effect on productivity, (2) fertilization limits, (3) uptake and assimilation of nitrogen parameters, (4) monoculture practice effect, and (5) possible sources and strategies. One hundred eleven articles of different scientific platforms were revised and data were collected. Information from articles was used to calculate the partial factor productivity for nitrogen (PFPN), the apparent use efficiency of N (APUEN), available nitrogen (AN), and nitrogen content harvested in grains (HarvN). Quinoa responds positively to fertilization, but differences in yield were found among irrigated and rainfed conditions. Quinoa can produce 1850 kg grains ha−1 with 50 kg N ha−1 under irrigated conditions, and 670 kg grains ha−1 with 15 kg N ha−1 in rainfed conditions. Quinoa increases seed yield and HarvN increases N fertilization, but decreases nitrogen efficiency. In Altiplano, without nitrogen fertilizer, the quinoa yield relies on between 500 and 1000 kg ha−1, which shows that in the soil, there are other nitrogen sources.