Nitrogen (N) is a key input to food production. Nearly half of N fertilizer input is not used by crops and is lost into the environment via emission of gases or by polluting water bodies. It is essential to achieve production levels, which enable global food security, without compromising environmental security. The N pollution level expected by 2050 is projected to be 150% higher than in 2010, with the agricultural sector accounting for 60% of this increase. In this paper, we review the status of the pollution from N fertilizers worldwide and make recommendations to address the situation. The analysis reviews the relationship between N fertilizer use, N use efficiency, no-point pollution, the role of farmer management practices, and policy approaches to address diffuse pollution caused by N fertilization. Several studies show a lack of information as one of the main hurdles to achieve changes in habits. The objective of this study is to highlight the gravity of the current global non-point pollution as well as the need for a communication effort to make farmers aware of the relationship between their activity and N pollution and, therefore, the importance of their fertilizer management practices.