Objective To analyze the changing trends in snail status and schistosomiasis prevalence in Zhejiang Province from 2001 to 2024, and provide a scientific basis for improving prevention and control strategies during thd post-elimination maintenance phase.

Methods Annual schistosomiasis surveillance data from Zhejiang Province (2001–2024) were collected, and Joinpoint regression models were used to analyze temporal trends in snail distribution and human infection. The annual average percent change (AAPC) and annual percent change (APC) were calculated to assess temporal trends.

Results From 2001 to 2024, the total snail survey area in Zhejiang Province was 1,498.2329 million m², and the snail found area was 14.5386 million m². Joinpoint regression analysis indicated a significant overall decline in the snail found area (AAPC=−3.58%, P<0.05), with two joinpoints identified in 2007 and 2014, specifically demonstrating an 11.36% annual average decline during the sub-period of 2007-2014. Concurrently, the proportion of snail found areas within surveyed regions declined annually by 3.93%. The total snail area decreased at an annual average rate of 1.50%, among which the snail area in hilly regions showed a more pronounced decline of 1.92% per year, while that in marshland areas increased. Notably, the proportion of marshland snail areas within the total snail area exhibited one joinpoint in 2018, shifting from an annual average decline to a steep annual increase of 63.41% from 2018 to 2024. The seropositivity rate for schistosomiasis in the province declined at an annual average rate of 10.47% from 2001 to 2024. During the same period, a total of 249 imported fecal-positive cases were reported, with cases decreasing at an annual average rate of 6.76%, and a joinpoint was identified in 2005 characterized by an initial increase followed by a decrease; from 2005 to 2024, the annual average decline was 19.84%.

Conclusion Schistosomiasis elimination achievements in Zhejiang Province were consolidated from 2001 to 2024, with substantial reductions in snail areas. However, risks persist due to residual snails and imported cases. Therefore, further efforts are needed to strengthen surveillance and control of snail habitats and imported sources of infection to sustain the elimination achievement.