Given the low water and fertiliser use efficiency and the extensive distribution of sand interlayered soil in the Hetao irrigation district (HID), this study aimed to investigate the effects of different irrigation and fertilisation regimes on root parameters and yield in spring maize grown in sand interlayered soil. A two-year field plot experiment was conducted using the spring maize “Ximeng 3358” under three irrigation and nitrogen levels. Root length (RL), surface area (RS), diameter (RD), volume (RV), and length density (RLD), grain yield, and water use efficiency (WUE) were examined. Root growth was inhibited at the sand layer, with approximately 72.46–87.37% of the roots concentrated in the 0–40 cm soil layer. Notably, the proportion of roots in the bottom layer was 24.61–87.37% higher than that in the sub-bottom layer. Moreover, RL, RS, RD, and RV peaked in the medium irrigation and nitrogen fertilisation (I2F2) treatment. Furthermore, correlation analysis showed that the root parameters were significantly positively correlated with yield and WUE, with RS being most correlated to yield and WUE. Roots at a narrow row spacing of 20 cm (NR20) and at a depth of 10–20 cm were strongly correlated with yield and WUE. Conclusively, the I2F2 treatment can be used as the optimal combination of water and nitrogen for sand interlayered soil farmlands.