Abstract: Objective To analyze the epidemiological characteristics and etiological distribution of influenza by monitoring Influenza-Like Illness (ILI) cases in Xiaogan City, so as to provide a scientific basis for influenza prevention and control.Methods Surveillance data on influenza-like illness (ILI) reported by sentinel hospitals and influenza virus test data reported by network laboratories from 2020 to 2024 were collected and analyzed. Results A total of 781,528 outpatient and emergency cases were reported by sentinel hospitals, among which 34,078 were ILI , with an ILI proportion (ILI%) of 4.36%. The 0-<5 years age group had the highest constituent ratio of ILI (28.62%, 9,754/34,078). A total of 11,000 surveillance samples were tested, and 1,515 were positive for influenza virus, with an overall positive rate of 13.77%. Among the positive samples, 724 were influenza A (H3N2) subtype (47.79%), 232 were influenza A (H1N1) subtype (15.31%), 554 were influenza B (Victoria lineage) (36.57%), and 5 were mixed infections (0.33%). The difference in the seasonal distribution of influenza viruses was statistically significant (χ²=9120.634, P < 0.001). The epidemic peaks mainly occurred in winter and spring, and summer epidemic peaks were only observed in 2021 and 2022. There was a statistically significant difference in age distribution (χ²=846.607, P < 0.001), with the 5-<15 years age group showing the highest influenza positive rate. No statistically significant difference was found in gender distribution (χ²=2.427, P=0.658).Conclusion The influenza epidemic period in Xiaogan City is mainly in winter and spring, with occasional summer peaks. Prevention and control efforts should focus on children and adolescents aged 5-<15 years as well as key settings such as schools. It is necessary to continuously strengthen influenza surveillance to provide a scientific basis for formulating prevention and control strategies.