Precise water management is imperative for sustainable crop production under irrigation in semi-arid regions with increasingly variable rainfall. Water use efficiencies achieved by farmers often differ widely, even within regions with homogenous agro-ecological conditions. To better understand the drivers of this variability and derive management recommendations, detailed measurements of water and associated nutrient dynamics were conducted on 20 potato farms in two regions of South Africa. Crop characteristics and typical growing conditions in South Africa make potato cultivation sensitive to water and nutrient losses. Water and nutrient inputs and losses through drainage and plant uptake were measured in potato and the follow-up crop, along with yield and weather variables. Seasonal mean irrigation and evapotranspiration were lower in winter crops (240 mm irrigation, 236 mm evapotranspiration) than in summer crops (598 mm irrigation, 608 mm evapotranspiration). Seasonal field water balances were often close to zero, indicating that estimations of evapotranspiration and drainage were representative for the greater field. Lysimeter observations however appeared more representative in sandy unstructured soils than in heavier structured soils. Rainfall during cropping reduced demand for irrigation and increased water use efficiency based on irrigation water, but caused substantial drainage. Leaching of N and K was considerable (on average 30 kg N, 55 kg K ha−1, much higher in some fields), while P leaching was negligible, with the exception of one field (51 kg P ha−1). Variation in water and nutrients use efficiencies was the result of management decisions and environmental factors, such as rainfall and soil type. Without substantial rainfall, application of irrigation scheduling tools can keep drainage and nutrient losses to a minimum, as was observed on almost half the fields, even on sandy soils with a low water holding capacity. Potato yields greatly varied among farmers (9.1–24.7 t dry matter tuber ha−1). Efficient farmers included those who used water sparsely and had minimal drainage, but also farmers who used inputs judiciously and obtained excellent productivity. The role of follow-up crops as users of surplus nutrients and water left behind by the potato crop was not always evident.