Recent decades have witnessed a huge change in the global structure of the human population, with the majority of people now living in urban environments. Rural-to-urban migration flows, mainly due to labour opportunities in urban areas, are responsible for the majority of this growth. Such events aggravate the urban-rural divide and compromise sustainable land-use systems. Hence, planning and managing urban areas and rural hinterlands require integrative spatial planning strategies, as well as strong land use management policies. In this regard, strategic spatial plans have been increasingly developed in many urban regions worldwide, as a means to achieve sustainable land use patterns, guide the location of physical infrastructures and shape urban-rural dynamics. It is realistic, therefore, to expect that strategic spatial plans may contribute to fostering the linkage between urban centres and rural hinterlands. This study reviews the content of strategic plans and other spatial policy documents currently in force in European and North American urban regions. The central goal of this study is to analyse the policies and measures in the plans to understand the role strategic spatial plans play in balancing the urban-rural nexus. The findings allow us to distinguish three dominant approaches, which reflect spatial patterns: i) strategic plans in European cases are focused on promoting brownfield redevelopment and stimulating polycentricity as a counter-urbanization measure; ii) strategic plans in Canadian cases demonstrate strong preoccupations with farmland protection for food security in striving for a more equal development of urban and rural areas; iii) strategic plans in assessed US cases are mainly focused on curbing urban sprawl and avoiding further land take for urban and infrastructure development, while rural hinterlands are largely neglected. The study concludes by outlining recommendations intended to support strategic planning processes and sustainable land management.