Optimized water-saving irrigation (WSI) practices are critical for enhancing resource use efficiency and ensuring sustainable wheat production in water-scarce regions. This meta-analysis quantitatively assessed the effects of various WSI methods on wheat yield, water use efficiency (WUE), and partial factor productivity of nitrogen (PFPN) across China’s wheat regions. The results showed that optimized irrigation, particularly drip and micro-sprinkler systems, significantly reduced irrigation water and nitrogen inputs by 35.1% and 7.2%, respectively, without yield penalties. Drip and micro-sprinkler irrigation, which together accounted for over 97% of observations, improved WUE by 18.7% and 10.1%, respectively, and increased PFPN by 6.8% and 5.5%, highlighting their dominant role in current WSI practices. Moderate deficit irrigation (60–100% of full irrigation) optimized WUE and PFPN while maintaining stable yields, whereas severe deficit irrigation (<40%) caused substantial yield losses. Soil texture and bulk density strongly modulated WSI effectiveness. Climatic factors, particularly growing season precipitation, negatively correlated with WSI benefits, highlighting enhanced efficiency gains under drier conditions. These findings emphasize the need to prioritize drip and micro-sprinkler irrigation in national water-saving strategies and advocate for integrated approaches combining WSI with soil health management and site-specific irrigation scheduling to promote sustainable wheat intensification under variable agroecological conditions.