Intensification of olive orchard management entails increased use of fertilizers, especially nitrogen, phosphorus, and potassium. In this review, plant responses to nutritional aspects, as well as environmental considerations, are discussed. Nutrient deficiency impairs production, whereas over-fertilization may reduce yields and oil quality, and increase environmental hazards and production costs. The effect of irrigation on nutrient availability and uptake is very significant. Application of organic matter (e.g., manure, compost) and cover crops can serve as substitutes for mineral fertilization with additional benefits to soil properties. Recycling of the pruned orchard material, olive pomace and olive mill wastewater, as well as the use of recycled wastewater for irrigation, are all potentially beneficial to olive orchard sustainability, but present the risk of environmental pollution. Some considerations regarding optimization of olive orchard nutrition are discussed.