Adopting the right agricultural conservation practices (CPs) at the right place is critical to maximizing water quality benefits. The Agricultural Conservation Planning Framework (ACPF) tool identifies all potential CPs and their locations within a target watershed based on the landscape characteristics. The ACPF tool suggests hundreds of CP locations in a watershed, making it challenging to prioritize the CP implementation. We develop and demonstrate an efficient approach using a multicriteria ranking technique for prioritizing the CPs suggested by ACPF, considering pollution hotspots and CP cost and effectiveness to support decision-makers. The pollution hotspots are estimated with simulations from an ecohydrological model, the Soil and Water Assessment Tool (SWAT). The CP cost and effectiveness were estimated from CP installation costs and pollutant reduction efficiencies from the literature. The methodology was demonstrated in the Conewago and Mahantango watersheds in Pennsylvania, US, for grassed waterways (GWWs) and water and sediment control basins (WASCOBs) for sediment load reduction. Multiple CP prioritization scenarios were evaluated with individual and combined criteria for reductions in total sediment load, yield (loading per area), and cost. In single criterion-based prioritization, the cost-based and load-based prioritization indicated cost efficiency and fewer CPs, respectively. The yield-based approach correctly prioritized CPs in sediment loss hotspots in the case study watersheds; however, it needed more CPs to meet the target reductions. The multicriteria approach efficiently prioritized CPs in sediment hotspots to meet target reductions. Although this approach was demonstrated in two case study watersheds and for sediment loss reduction, it is applicable for any location or pollutant for which similar input variables can be provided, thereby providing a means for prioritizing the results of ACPF for implementation in the Mid-Atlantic region of the US.