Vegetable production systems involve high rates of chemical and organic fertilizer applications, leading to significant P accumulation in vegetable soils, as well as a decrease in P use efficiency (PUE), which is one of the key limiting factors in vegetable production. This review introduces the vegetable production systems in China and their fertilization status, and analyzes probable causes of overfertilization of vegetable fields. Poorly developed root systems and high P demand have led to the need to maintain much higher available P concentrations in the root zone for regular growth of vegetables, which might necessitate higher phosphate fertilizer input than the plants require. Research on strategies to improve vegetable PUE and the mechanisms of these strategies are summarized in this review. Increasing the P uptake by vegetables by supplying P during the critical growth stage and effectively utilizing the accumulated P by optimizing the C:P ratio in soils can substantially increase PUE. These advances will provide a basis for improving PUE and optimizing phosphate fertilizer applications in vegetable production through regulatory measures. In addition, some policies are recommended that could ensure the safety of vegetables and improve product quality. This review also aims to improve understanding of P cycling in vegetable fields and assist in the development of best practices to manage P reserves globally.