China, the largest global producer and consumer of greenhouse tomatoes, faces significant challenges related to water shortages and inefficient use of water and fertilizers, which hinder sustainable agricultural development. This study aimed to evaluate the impact of different water and fertilizer application patterns on the growth and physiological characteristics of greenhouse tomatoes. A pot experiment was conducted at Yuncheng University in Shanxi Province, using three irrigation levels: I1 (90%-100% field water holding capacity), I2 (72%-80% field water holding capacity), and I3 (54%-60% field water holding capacity). Four fertilizer application patterns were tested: C1 (soluble organic and chemical fertilizer), C2 (soluble chemical fertilizers only), C3 (sheep manure and chemical fertilizer), and C4 (soluble organic fertilizers only). The results demonstrated significant positive relationships between leaf area (LA), leaf SPAD value, dry matter, and fruit dry matter with the fruit yield of greenhouse tomatoes. The average fruit yield per plant was 2.47 kg under I1, 2.32 kg under I2, and 2.01 kg under I3. Among the fertilizer treatments, C1 was most effective in enhancing LA, stem growth, leaf SPAD, and dry matter of greenhouse tomatoes, showing the greatest dry matter and root-shoot ratio under I2. Conversely, C3 resulted in the highest water consumption at each growth stage but yielded the lowest dry matter and fruit yield under I2. C2 showed the highest water consumption during the seedling, fruit enlargement, and harvest stages under I3 yet consistently produced lower fruit yield and dry matter mass compared to C1. Water Use Efficiency (WUE) significantly decreased with increased irrigation. Under the same irrigation level, WUE followed the order C1 > C2 > C4 > C3, while fruit yield followed the order C1 > C2 > C3 > C4. Overall, the I1C1 treatment was most conducive to promoting fruit yield (2.59 kg per plant), while I2C1 could achieve water-saving greenhouse tomato production in the semi-arid areas of China.