Judicious phosphorus (P) management is a global grand challenge and critical to achieving and maintaining water quality objectives while maintaining food production. The management of point sources has been successful in lowering P inputs to aquatic environments, but more difficult is reducing P discharges associated with diffuse sources, such as non-point runoff from agriculture and urban landscapes, as well as P accumulated in soils and sediments. Strategies for effective diffuse-P management are imperative. Many options are currently available, and the most cost-effective and practical choice depends on the local situation. This critical review describes how the metrics of P quantity in kg ha-1 yr-1 and P form can influence decision-making and implementation of diffuse-P management strategies. Quantifying the total available pool of P, and its form, in a system is necessary to inform effective decision-making. The review draws upon a number of ‘current practice’ case studies that span agriculture, cities, and aquatic sectors. These diverse examples from around the world highlight different diffuse-P management approaches, delivered at the source in the catchment watershed or at the aquatic sink. They underscore workable options for achieving water quality improvement and wider P sustainability. The diffuse-P management options discussed in this critical review are transferable to other jurisdictions at the global scale. We demonstrate that P quantity is typically highest and most concentrated at the source, particularly at farm scale. The most cost-effective and practically implementable diffuse-P management options are, therefore, to reduce P use, conserve P, and mitigate P loss at the source. Sequestering and removing P from aquatic sinks involves increasing cost, but is sometimes the most effective choice. Recovery of diffuse-P, while expensive, offers opportunity for the circular economy.