Abstract: Objective To understand the epidemiological characteristics of hand, foot and mouth disease (HFMD) in children aged 5 years in China and provide scientific evidence for HFMD prevention and control. Methods Descriptive research methods and the visualization technology based on the geographic information system (GIS) were used to conduct systematic analysis on the HFMD surveillance data in China during 2008-2011. Results The total number of HFMD cases in children aged 5 years was 414 412 during this period, the average annual incidence was 139.63/10 000. The male to female ratio of the cases was 1.573:1. The cases in children aged 5 years accounted for 89.50% of the total. The cases were mainly distributed in region at 105.00-east longitude and 18.00-41.00 north latitude. The major pathogens were EV71 (51.04%), Cox A16 (27.32%) and other entericviruses (21.63%). Conclusion Population-based studies have shown that most cases occurred in children aged 5 years. The incidence in boys was higher than that in girls. Most cases were children outside child care settings. The incidence of HFMD increased with year and the regional specific difference was obvious. The areas with high incidences were mainly in eastern part of China, and the disease mainly spread from north to south (especially the costal area), from east to west. The area specific difference in HFMD incidence might be related with local climate, population density and pathogen constituent.