Soil aeration is known to alleviate root zone hypoxia, improve root growth environment, and enhance crop yield and water and fertilizer use efficiency. However, the specific effects of coupled soil aeration and fertilization on photosynthesis, chlorophyll content, yield, and quality of tomato remain unclear. To address this knowledge gap, greenhouse experiments were conducted for 2 years on tomato in Xi'an, China. In preliminary experiments, it was observed that the combination of venturi and two dispersers treatments could enhance air transfer distance within the drip irrigation system over a range of 0–25 m. Subsequently, in the planting experiments, 3 levels of aeration (A) were established: A1 (no aeration), A2 (7.50 % air-to-water ratio), and A3 (15.00 % air-to-water ratio), along with 3 fertilizer (F) levels: F1 (no additional fertilizer), F2 (N- P2O5-K2O fertilizer application rate of 120-60-78 kg ha−1), and F3 (N- P2O5-K2O fertilizer application rate of 240-120-150 kg ha−1). The study revealed that aeration significantly increased the photosynthetic rate, chlorophyll content, and dry matter content of tomatoes, resulting in a substantial improvement in both yield and quality. Additionally, aeration was found to enhance fertilizer use efficiency (FUE) and water use efficiency (WUE). In 2021, fertilizer increased the Chl. b content and improved photosynthesis, ultimately enhancing the yield, vitamin C, and total soluble sugars in tomatoes. Under the A3F1 treatment, FUE was the highest, while WUE was the highest under the A3F3 treatment. The A1F1 treatment resulted in the lowest tomato yield, with 37.22 t/ha in 2021 and 39.85 t/ha in 2022. The A3F3 treatment consistently produced the highest yield, achieving 50.53 t/ha in 2021 and 51.11 t/ha in 2022. The A1F3 treatment exhibited the highest return on investment. These findings are of paramount importance for optimizing tomato cultivation practices, improving fertilizer efficiency, and promoting sustainable agricultural production.