Nitrogen inputs restructure ecosystems and can interact with other agents of ecological change and potentially intensify them. To examine the effects of nitrogen combined with those of elevation and competition, in 2005 we mapped vegetation and elevation within experimental plots that have been fertilized since 1970 in Great Sippewissett salt marsh, Cape Cod, MA, USA and compared the resulting effects on marsh vegetation. Decadal-scale chronic nutrient enrichment forced changes in cover and spatial distribution of different species. With increasing enrichment, there was a shift in species cover primarily involving loss of Spartina alterniflora and an increase in Distichlis spicata. Percent cover of near monocultures increased with nitrogen fertilization, owing mainly to the proliferation of D. spicata. The experimental fertilization prompted a shift from the short form of S. alterniflora to taller forms, hence increasing above-ground biomass, where this species managed to remain. Chronic enrichment increased upper and lower limits of the elevation range within which certain species occurred. The shift to increased cover of D. spicata was also associated with faster accretion of the marsh surface where this species was dominant, but not where S. alterniflora was dominant. Interactions among nutrient supply, elevation, and competition altered the direction of competitive success among different species of marsh plants, and forced changes in the spatial distribution and composition of the salt marsh plant communities. The results imply that there will be parallel changes in New England salt marshes owing to the widespread eutrophication of coastal waters and the increasing sea level rise. Knowing the mechanisms structuring marsh vegetative cover, and their role in modification of salt marsh accretion, may provide background with which to manage maintenance of affected coastal wetlands.