Soil salinity and alkalinity can inhibit crop growth and reduce yield, and this has become a global environmental concern. Combined changes in nitrogen (N) application and hill density can improve rice yields in sodic saline–alkaline paddy fields and protect the environment. We investigated the interactive effects of N application rate and hill density on rice yield and N accumulation, translocation and utilization in two field experiments during 2018 and 2019 in sodic saline–alkaline paddy fields. Five N application rates (0 (control), 90, 120, 150, and 180 kg N ha?1 (N0–N4), respectively) and three hill densities (achieved by altering the distance between hills, in rows spaced 30 cm apart: 16.5 cm (D1), 13.3 cm (D2) and 10 cm (D3)) were utilized in a split-plot design with three replicates. Nitrogen application rate and hill density significantly affected grain yield. The mathematical model of quadratic saturated D-optimal design showed that with an N application rate in the range of 0–180 kg N ha?1, the highest yield was obtained at 142.61 kg N ha?1 which matched with a planting density of 33.3×104 ha?1. Higher grain yield was mainly attributed to the increase in panicles m–2. Nitrogen application rate and hill density significantly affected N accumulation in the aboveground parts of rice plants and showed a highly significant positive correlation with grain yield at maturity. From full heading to maturity, the average N loss rate of the aboveground parts of rice plants in N4 was 70.21％ higher than that of N3. This is one of the reasons why the yield of N4 treatment is lower than that of the N3 treatment. Nitrogen accumulation rates in the aboveground parts under treatment N3 (150 kg N ha?1) were 81.68 and 106.07％ higher in 2018 and 2019, respectively, than those in the control. The N translocation and N translocation contribution rates increased with the increase in the N application rate and hill density, whereas N productivity of dry matter and grain first increased and then decreased with the increase in N application rate and hill density. Agronomic N-use efficiency decreased with an increase in N application rate, whereas hill density did not significantly affect it. Nitrogen productivity of dry matter and grain, and agronomic N-use efficiency, were negatively correlated with grain yield. Thus, rice yield in sodic saline–alkaline paddy fields can be improved by combined changes in the N application rate and hill density to promote aboveground N accumulation. Our study provides novel evidence regarding optimal N application rates and hill densities for sodic saline–alkaline rice paddies.