Despite the significant impacts of biomass burning (BB) on global climate change and regional air pollution, there is a relative lack of research on the temporal trends and geographic patterns of BB in Northeast China (NEC). This study investigates the spatial–temporal distribution of BB and its impact on the atmospheric environment in the NEC region during 2004 to 2023 based on remote sensing satellite data and reanalyzed data, using the Siegel’s Repeated Median Estimator and Mann–Kendall test for trend analysis, HDBSCAN to identify significant BB change regions, and Moran’s Index to examine the spatial autocorrelation of BB. The obtained results indicate a fluctuating yet overall increasing BB trend, characterized by annual increases of 759 for fire point counts (FPC) and 12,000 MW for fire radiated power (FRP). BB predominantly occurs in the Songnen Plain (SNP), Sanjiang Plain (SJP), Liaohe Plain (LHP), and the transitional area between SNP and the adjacent Greater Khingan Mountains (GKM) and Lesser Khingan Mountains (LKM). Cropland and urban areas exhibit the highest growth in BB trends, each surpassing 60% (p < 0.05), with the most significant growth cluster spanning 68,634.9 km2. Seasonal analysis shows that BB peaks in spring and autumn, with spring experiencing the highest severity. The most critical periods for BB are March–April and October–November, during which FPC and FRP contribute to over 80% of the annual total. This trend correlates with spring planting and autumn harvesting, where cropland FPC constitutes 71% of all land-cover types involved in BB. Comparative analysis of the aerosol extinction coefficient (AEC) between areas with increasing and decreasing BB indicates higher AEC in BB increasing regions, especially in spring, with the vertical transport of BB reaching up to 1.5 km. County-level spatial autocorrelation analysis indicates high–high clustering in the SNP and SJP, with a notable resurgence of autocorrelation in the SNP, suggesting the need for coordinated provincial prevention and control efforts. Finally, our analysis of the impact of BB on atmospheric pollutants shows that there is a correlation between FRP and pollutants, with correlations for PM2.5, PM10, and CO of 0.4, 0.4, and 0.5, respectively. In addition, the impacts of BB vary by region and season, with the most significant impacts occurring in the spring, especially in the SNP, which requires more attention. In summary, considering the escalating BB trend in NEC and its significant effect on air quality, this study highlights the urgent necessity for improved monitoring and strategic interventions.