Under the effects of saltwater intrusion from rising sea water levels, climate change, and socioeconomic issues, the Nga Nam district in Vietnam has suffered damage to its agriculture and changes in agricultural land use. This study aimed to investigate the factors that influenced land use changes and to propose approaches to limit the changes in agricultural land use. The damage caused by saltwater intrusion on agricultural production was evaluated via the use of secondary data collected from the Department of Infrastructure Economics of the Nga Nam district in the period
of 2010–2021. The results show that during the 2010–2015 period, agricultural production areas were affected in 2010, 2012, and 2015. In the period of 2015–2021, the trend of saltwater intrusion along the damaged area remarkably decreased due to the work of saltwater-preventing structures. In this period, the area of annual plants increased, while that of fruit trees decreased. In the area comprising annual plants, the area using the triple rice land use type converted into an area using the double rice and double rice–fish ones. Lands for fruit trees transitioned from mixed farming to specialized farming to raise the economic efficiency for farmers. These changes were affected by four main factors: the physical factor, the economy, society, and the environment. The environmental and economic factors were seen to play the most important role as drivers of changes in land use. The factors of saltwater intrusion and acid-sulfate-contaminated soil, consumer markets, floods, drought, profit, and investments were noted to be significant drivers in agricultural land use change. Thus, both structural and non-structural approaches are suggested to inhibit the safeguard changes in the future.