Processing tomato is a main source of phytomicronutrients in the human diet due to its micronutrient content, and the diversity of derived products consumed worldwide. A large proportion of processing tomatoes are grown under Mediterranean climate where increasing water scarcity and heat are expected to reduce yields and to have negative impacts on fruit quality. Despite this, the effects of changes in fresh fruit quality on processing and end-product quality have been under-investigated. It therefore seems imperative to work along the food chain to improve food sustainability while maintaining quality and access to important phytonutrients. The present study adopts a holistic approach from field to processing plant, assessing the effects of reduced water and nitrogen supplies on yields, fresh fruit quality and suitability for processing, and puree quality. The 5-year trial included eight varieties, several levels of water and nitrogen supply, and two processes. It was found that water deficit induced a decrease in fresh commercial yield, partially compensated by an increase in dry matter content. The yield loss was the result of a lower number of fruits per plant, while the average fruit weight and biochemical composition showed little change. Water use efficiency decreased above 120% of water demand restoration and improved under low nitrogen supply. Puree viscosity and dry matter content increased with water deficit with beneficial effects for the industry, while the reduction of nitrogen supply did not affect puree quality. This work highlighted the possibility of monitoring quality traits in tomato puree directly from field. Nevertheless, the trade-offs between WUE, quality and yield need to be optimized. Selection of varieties rich in lycopene could be a promising avenue as they appear more tolerant to water deficit. This work also stressed the need to reassess the crop coefficient for new varieties, to improve evaluation of water needs.