Transport of phosphorus (P) from agricultural fields to water bodies deteriorates water quality and causes eutrophication. To reduce P losses and optimize P use efficiency by crops, better knowledge is needed of P turnover in soil and the efficiency of best management practices (BMPs). In this review, we examined these issues using results from 10 Swedish long-term soil fertility trials and various studies on subsurface losses of P. The fertility trials are more than 50 years old and consist of two cropping systems with farmyard manure and mineral fertilizer. One major finding was that replacement of P removed by crops with fertilizer P was not sufficient to maintain soil P concentrations, determined with acid ammonium lactate extraction. The BMPs for reducing P leaching losses reviewed here included catch crops, constructed wetlands, structure liming of clay soils, and various manure application strategies. None of the eight catch crops tested reduced P leaching significantly, whereas total P loads were reduced by 36% by wetland installation, by 39 to 55% by structure liming (tested at two sites), and by 50% by incorporation of pig slurry into a clay soil instead of surface application. Trend analysis of P monitoring data since the 1980s for a number of small Swedish catchments in which various BMPs have been implemented showed no clear pattern, and both upward and downward trends were observed. However, other factors, such as weather conditions and soil type, have profound effects on P losses, which can mask the effects of BMPs.