We analyze the combined effects of the spatial variability of soil hydraulic properties and the water uptake by plant roots on unsaturated water flow. For this analysis, we use a simplified macroscopic root water uptake model which is usually applied only for homogeneous or layered soil and therefore we also determine whether it is applicable for multidimensional heterogeneous media. Analytical solutions for mean and variance of pressure head (first-order second-moment approximations) in layered media and numerical solutions of two-dimensional (2-D) autocorrelated multi-Gaussian and non multi-Gaussian parameter fields are analyzed for steady state and transient flow conditions. For non-Gaussian topological features, that have little influence on the mean and the variance of the pressure field if root water uptake is ignored, we test whether the influence is significant if root water uptake is accounted for. The results reveal that, in field structures with large patches of coarse material, local regions with pressure head values at the wilting point develop; these are surrounded by wet material. Without a compensation mechanism for local stress, the global transpiration demand is not met if local wilting occurs. Various compensation mechanisms are tested that depend, respectively, on the saturation, the relative conductivity or a strategy where the deficit in the global uptake rate is equally distributed to unstressed locations. The strategies lead to a global actual transpiration rate at the potential value and attenuate the formation of locally wilted areas. Wilted regions can, however, still occur, and may be an artifact of the simplified model concept as root-soil interactions are neglected. Therefore simplified macroscopic models for root water uptake should be used with caution in heterogeneous media.