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At present, excessive nutrient inputs caused by human activities have resulted in environmental problems such as agricultural non-point source pollution and water eutrophication. The Net Anthropogenic Nitrogen Inputs (NANI) model can be used to estimate the nitrogen (N) inputs to a region that are related to human activities. To explore the net nitrogen input of human activities in the main grain-producing areas of Northwestern China, the county-level statistical data for the Ningxia province and NANI model parameters were collected, the spatio-temporal distribution characteristics of NANI were analyzed and the uncertainty and sensitivity of the parameters for each component of NANI were quantitatively studied. The results showed that: (1) The average value of NANI in Ningxia from 1991 to 2019 was 7752 kg N km−2 yr−1. Over the study period, the inputs first showed an overall increase, followed by a decrease, and then tended to stabilize. Fertilizer N application was the main contributing factor, accounting for 55.6%. The high value of NANI in Ningxia was mainly concentrated in the Yellow River Diversion Irrigation Area. (2) The 95% confidence interval of NANI obtained by the Monte Carlo approach was compared with the results from common parameters in existing literature. The simulation results varied from −6.4% to 27.4% under the influence of the changing parameters. Net food and animal feed imports were the most uncertain input components affected by parameters, the variation range was −20.7%–77%. (3) The parameters of inputs that accounted for higher proportions of the NANI were more sensitive than the inputs with lower contributions. The sensitivity indexes of the parameters contained in the fertilizer N applications were higher than those of net food and animal feed imports and agricultural N-fixation. This study quantified the uncertainty and sensitivity of parameters in the process of NANI simulation and provides a reference for global peers in the application and selection of parameters to obtain more accurate simulation results. MAX and MIN are the upper and lower limits of the confidence interval, respectively, AVE is the Monte Carlo simulation average value, OPT is the calculation result using common parameters from the existing literature. [Display omitted] • Spatio-temporal change NANI of Ningxia in China from 1991 to 2019 was analyzed. • Fertilizer N application was a primary source of NANI in the studied region. • The Monte Carlo method for uncertainty of the NANI model parameter was integrated. • The most sensitive parameter was in the chemical fertilizer application component. [ABSTRACT FROM AUTHOR]