Agricultural activities are responsible for most of the nitrogen (N) inputs that degrade water quality. To elucidate the drivers leading to N pressures on water, we examined the resulting state of surface waters in terms of N concentrations, the impact of this on water quality status and policy responses to these constraints across different climatic and management conditions. Portugal and Denmark were chosen as contrasting case studies for the Driver-Pressure-State-Impact-Response (DPSIR) analysis. Our results showed reductions of 39% and 25% in the use of mineral fertilizer in Portugal and Denmark, respectively, between 2000 and 2010. The N surplus in Portugal varied between 15 and 30 kg N ha−1 between 1995 and 2015. In Denmark, in 2015, this amount was 70 kg N ha−1, representing a 53% decrease from the 1990 value. The average amount of total N discharged to surface waters was 7 kg ha−1 for mainland Portugal in 2015 and 14.6 kg ha−1 for Denmark in 2014. These reductions in the N surplus were attributed to historical policies aimed at N pressure abatement. In Denmark, N losses are expected to decline further through the continuation or improvement of existing national action plans. In Portugal, they are expected to decline further due to the expansion of Nitrate Vulnerable Zones and the introduction of targeted policies aimed at improving N use efficiency and reducing losses to water.