The plant bug Lygus pratensis Linnaeus (Hemiptera: Miridae) is an important insect pest of alfalfa in grassland farming in northern China. A field population of L. pratensis was selected in the laboratory for 14 consecutive generations with lambda-cyhalothrin to generate 42.555-fold resistance. Selection also induced low cross-resistance to imidacloprid and beta-cypermethrin, and medium cross-resistance to deltamethrin. Realized heritability (h2) of lambda-cyhalothrin resistance was 0.339. Susceptible baselines of L. pratensis were established for five insecticides using the glass-vial method, the values of which were 6.849, 3.423, 8.778, 3.559, and 117.553 ng/cm² for phoxim, methomyl, imidacloprid, lambda-cyhalothrin, and avermectin, respectively, along with the calculated LC₉₉ diagnostic doses. This resistance risk assessment study suggests that a high risk of lambda-cyhalothrin resistance exists in the field. In addition, a 5-year field investigation of resistance monitoring of L. pratensis was conducted in seven alfalfa regions in farming-pastoral ecotones in northern China. The resistance levels of most populations were very low for phoxim, methomyl, and avermectin, with an upward trend for lambda-cyhalothrin resistance in the DK (Dengkou County), TKT (Tuoketuo County), XL (Xilinhot), and LX (Linxi County) populations during 2015–2019, and medium resistance level to imidacloprid in the TKT population in five years we sampled. The study provided information on chemical control, lambda-cyhalothrin resistance development, baseline susceptibility, and the status of resistance to five commonly-used insecticides against L. pratensis.These results could be used to optimize pyrethroid insecticide use as part of a pest integrated resistance management strategy against this key insect pest of alfalfa.