Objective To understand the spatiotemporal distribution of hand, foot, and mouth disease (HFMD) and its changing trends in Xinjiang Uygur autonomous region from 2014 to 2024, and provide evidence for the development of targeted prevention measures of HFMD in Xinjiang.

Methods The monthly incidence data of HFMD in all the counties (districts) of Xinjiang from 2014 to 2024 were collected from China Disease Prevention and Control Information System. Spatial distribution mapping, spatial autocorrelation analysis, and spatiotemporal scanning were performed to identify spatiotemporal clustering patterns of HFMD. The significance level was set at α = 0.05.

Results From 2014 to 2024, a total of 65,727 HFMD cases were reported in Xinjiang, with the overall incidence rate showing a significant downward trend (χ²trend = 1 180.00, P<0.001). The incidence rate was generally higher in northern Xinjiang than in southern Xinjiang. A positive spatial correlation was observed in the annual HFMD incidence during the study period (Moran’s I>0, P<0.01). Local spatial autocorrelation analysis revealed that low-low clustering areas were mainly in southwestern Xinjiang and remained stable, whereas high-high clustering areas were in parts of northern Xinjiang but decreased markedly after 2020. Spatiotemporal scanning further indicated that the primary clustering areas were mainly in northern Xinjiang, while the secondary clustering areas were smaller and distributed in southern Xinjiang. The annual clustering mainly occurred from May to November with a delay being observed after 2020.

Conclusions From 2014 to 2024, the overall incidence of HFMD in Xinjiang exhibited a downward trend. The risk and intensity of HFMD outbreaks in northern Xinjiang were generally higher than those in southern Xinjiang. However, the risk of outbreaks in southern Xinjiang showed an increasing trend. In the HFMD epidemic season, intensified surveillance and risk assessment should be implemented in northern Xinjiang, while close attention should be paid to any unusual increase in cases in southern Xinjiang.