The objective of this research was to develop an active crop sensor-based precision rice (Oryza sativa L.) management (PRM) strategy to improve rice yield, N and water use efficiencies and evaluate it against farmer’s rice management in Northeast China. Two field experiments were conducted from 2011 to 2013 in Jiansanjiang, Heilongjiang Province, China, involving four treatments and two varieties (Kongyu 131 and Longjing 21). The results indicated that PRM system significantly increased rice grain yield, N recovery efficiency (RE), agronomic efficiency (AE) and partial factor productivity (PFP) by an average of 12%, 63%, 89% and 53% over FP system across two varieties and the three years, respectively. Water use efficiency was increased by 59-60%. It is concluded that the PRM system can significantly increase rice yield, N and water use efficiencies than farmer’s practices and has the potential to contribute to both food security and sustainable development.