Potatoes (Solanum tuberosum) are the most important noncereal crop in the world. Increasing potato production is critical for future global food security. China is the world’s largest potato producer, and potato productivity is constrained by water scarcity and poor fertilizer use efficiency (NUEF). Recently, autumn film mulched ridge microfurrow rainwater harvesting (ARF) tillage has been successfully applied in potato production in dryland farming in Northwest China. However, the effects of ARF on the use efficiency (NUEF) of applied nitrogen (N), phosphorus (P), and potassium (K) nutrients in potatoes have not been systematically studied. A 3-year, consecutive field trial with four treatments, including moldboard planting without fertilizer application (control, CK), spring and autumn film mulched ridge microfurrow rainwater harvesting planting (SRF and ARF), and standard film mulched ridge-furrow planting (FRF), was conducted during 2018–2020. ARF greatly increased the water levels in the 0–200 cm soil profile at potato harvest compared to SRF, FRF, and CK. ARF and SRF significantly increased the levels of soil organic carbon (SOC), total and available NPK (TN, TP, TK and AN, AP, AK) compared to FRF and CK, with ARF being the most efficient at increasing the levels of the AN, AP, and AK. ARF significantly improved the soil water and nutrient activity and contributed the most to potato tuber and biomass yield and hence the NUEF. Under ARF, significant and positive associations were observed between the soil fertility traits, soil water storage (SWS), potato tuber yield, biomass yield, and NUEF. Soil fertility traits and the SWS were positively correlated with potato tuber and biomass yield. The SWS, potato tuber, and biomass yield positively correlated with the partial factor productivity (PFP) and the recovery efficiency (RE) of the applied NPK nutrients. Increased nutrient levels and their combination increased the NUEF and NUEF’s components. The TN and AN contributed more significantly to the PEP and agronomic efficiency (AE) of the applied NPK nutrients; the TP was significantly positively correlated with the AE (AEN, AEP, and AEK), while the AP was correlated with PEP (PFPN, PFPP, and PFPK) and RE (REN, REP, and REK); the TK was significantly positively correlated with the PFP and RE of the applied PK nutrients, while the AK was significantly positively correlated with the PEP, AE, and RE of the applied K nutrients. Therefore, ARF results in a synchronous increase in yield and NUEF and is the most efficient planting system for potato production in dryland farming.