Wheat production is threatened by water shortages and groundwater over-draft in the North China Plain (NCP). In recent years, winter wheat has been increasingly sown extremely late in early to mid-November after harvesting cotton or pepper. To improve water use efficiency (WUE) and guide the extremely late sowing practices, a 3-year field experiment was conducted under two irrigation regimes (W1, one-irrigation, 75 mm at jointing; W2, two-irrigation, 75 mm at jointing and 75 mm at anthesis) in 3 cultivars differing in spike size (HS4399, small spike; JM22, medium spike; WM8, large spike). Wheat was sown in early to mid-November at a high seeding rate of 800-850 seeds m(-2). Average yields of 7.42 t ha(-1) and WUE of 1.84 kg m(-3) were achieved with an average seasonal evapotranspiration (ET) of 404 mm. Compared with W2, wheat under W1 did not have yield penalty in 2 of 3 years, and had 7.9% lower seasonal ET and 7.5% higher WUE. The higher WUE and stable yield under W1 was associated with higher 1000-grain weight (TGW) and harvest index (HI). Among the 3 cultivars, JM22 had 5.9%-8.9% higher yield and 4.2%-9.3% higher WUE than WM8 and HS4399. The higher yield in JM22 was attributed mainly to higher HI and TGW due to increased post-anthesis biomass and deeper seasonal soil water extraction. In conclusion, one-irrigation with a medium-sized spike cultivar JM22 could be a useful strategy to maintain yield and high WUE in extremely late-sown winter wheat at a high seeding rate in the NCP.