Abstract: Ruichang yam (Dioscorea opposita), a characteristic economic crop in Jiangxi Province, faces severe challenges due to continuous cropping obstacles hindering sustainable production by causing soil degradation, pest accumulation, and yield reduction. Therefore, a field experiment was conducted from 2022 to 2024 in a typical red soil dryland area of Jiangxi Province aiming to identifying efficient and sustainable cropping patterns mitigating continuous cropping obstacles and enhance comprehensive system benefits. Four multiple-cropping patterns were designed: Chinese milk vetch-Chinese yam (CK, control), ryegrass-Chinese yam||spring maize-mung bean (B), hairy vetch-Chinese yam||soybean-autumn maize (C), and rapeseed-Chinese yam||peanut-sesame (D). Grey relational analysis was employed to evaluate crop productivity and comprehensive benefits across economic, ecological, and social dimensions. The results demonstrated that multiple cropping patterns (B, C, and D) significantly outperformed the CK pattern in terms of economic yield, straw yield, and total biomass, with increases ranging 3.14–8.16, 2.89–3.75, and 2.97–5.14 times, respectively. Over the two-year study, pattern C (hairy vetch-Chinese yam||soybean-autumn maize) exhibited the highest weighted correlation degrees in economic (0.404), ecological (0.312), and social (0.152) benefits. Specifically, pattern C achieved the highest values in key indicators, including total output value, net output value, output-input ratio, agricultural profit rate, straw incorporation amount, soil-improving crop index, crop diversity index, labor net productivity rate, and grain and oilseed yield. These results indicate that the pattern C effectively optimizes resource allocation, enhances system productivity, and improves sustainability. The superior performance of pattern C can be attributed to its rational species combination and efficient spatiotemporal arrangement. The legume-cereal intercropping system (soybean and autumn maize) facilitates biological nitrogen fixation and improves light and temperature utilization, thereby increasing both economic and ecological returns. Additionally, the incorporation of hairy vetch as green manure further enhances soil fertility and structure. This pattern not only significantly alleviates continuous cropping obstacles, but also ensures high and stable yields, making it a suitable strategy for improving land productivity and promoting green agricultural development in red soil drylands. Conclusively, the hairy vetch-Chinese yam||soybean-autumn maize model can achieve “high yield-high efficiency-sustainable” collaborative optimization through efficient allocation of resources, which is a suitable model to solve the continuous cropping obstacle of Chinese yam in red soil dryland and improve the comprehensive productivity of land, and it can provide technical options for the green development of regional dryland agriculture.