In arid and semi-arid sub-tropical regions of India, pearl millet [Pennisetum glaucum (L.) R. Br.]-wheat (Triticum aestivum L.) cropping system is the most important system under irrigated conditions. However, it is very exhaustive cropping system and productivity of pearl millet-wheat system has become constant or marginally declined for the last three decades. The imbalanced use of fertilizers and high intensity farming activities declined the soil nutrient status and also deteriorate physical and biological properties of soil. Therefore, to maintain soil health and productivity, balanced fertilization based on soil testing is very essential. A study of balanced fertilization based on Soil Test Crop Response (STCR) approach was initiated in 2009 at Research Farm, CCSHAU, Hisar, with seven treatments viz. T-1-control, T-2-farm yard manure (FYM) @ 15 t ha(-1), T-3-recommended dose of nitrogen and phosphorus (RDN and P), T-4-STCR with target yield (TY) 3.0 t ha(-1), T-5-STCR with TY 3.5 t ha(-1), T-6-integrated STCR with TY 3.0 t ha(-1) + FYM and T-7-integrated STCR with TY 3.5 t ha(-1) + FYM. Integrated treatment (T-7) recorded the highest crop grain and straw yield followed by chemical fertilizers alone (T-3-T-5) whereas lowest grain and straw yield was found in control (T-1) after 10 cycles of pearl millet-wheat system. Application of FYM along with chemical fertilizers enhanced total N, P and K uptake by approximately 150, 192 and 150% respectively, over the control. However, soil organic carbon (SOC) and available nutrients were found maximum at early developmental stages and decreased at maturity. The long-term balanced nutrient management using STCR approach has improved soil nutrient status, SOC, pearl millet yield, nutrient uptake and use efficiency of fertilizers.