Nitrogen fertilizers have significantly enhanced rice yields over the past decades, but they also have substantial negative impacts on the environment. Excessive application of nutrients, particularly nitrogen, beyond crop requirements is linked to environmental losses. High nitrogen fertilizer input leads to low nitrogen use efficiency (NUE) due to the rapid loss of nitrogen through ammonia volatilization, denitrification, surface runoff, and leaching in the soil-flood water system. Enhancing the yield potential of rice- based cropping systems in response to the global call for carbon neutrality is a crucial research target. New approaches are needed to boost yields while maintaining or ideally reducing nitrogen application to maximize crop NUE. Improving NUE is crucial for addressing the intertwined challenges of environmental degradation, climate change, and food security. This review provides an in-depth exploration of strategies for improving nitrogen use efficiency, including soil health management, optimized fertilizer application, crop management practices, physiological and morphological approaches, exploiting symbiotic relationships, and genetic approaches, all aimed at enhancing rice productivity while addressing agricultural and environmental challenges caused by nitrogen losses, such as ammonia volatilization and leaching and promoting more sustainable farming practices. It also reduces the input costs, leading to a more sustainable agricultural economy and improved living standards for farming communities.