For the utilization of nitrogen and phosphorus in rural sewage tailwaters after biological treatment, four systems were examined regarding their ability to purify tailwaters of rural domestic sewage: a hydroponic vegetable system (HV), a subsurface flow constructed wetland (SFCW), a compound system with HV followed by SFCW (HV-SFCW), and a compound system with SFCW followed by HV (SFCW-HV). Parameters of the four systems were optimized to maximize the utilization efficiency of nitrogen and phosphorus, and the characteristics and pollutant removal efficiency of the process were investigated. Moreover, the edible security of vegetables was also evaluated. Results showed that the optimal hydraulic loadings for the four systems were 0.2, 0.3, 0.3, and 0.3 m3/(m2·d) (the lowest being the HV), respectively. In the combined system of HV-SFCW, high contribution proportions of the HV unit to the removal of chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) were obtained, reaching 46.7%, 58.1%, and 53.7%. The heavy metal content of plants harvested met the standards of the National Food Safety Standard Limit of Pollutants in Food (GB 2762-2012). Overall, the compound HV-SFCW system achieved the best performance, ensuring that effluent water quality met national standards and realized the effective utilization of nitrogen and phosphorus.