Abstract: Objective: To analyze the epidemiological and etiological characteristics of hand--foot-- and-mouth disease (HFMD) in Jinjiang District of Chengdu City from 2014 to 2024, and provide a reference basis for HFMD prevention and control. Methods A retrospective study was conducted to collect confirmed and clinically diagnosed cases of HFMD in Jinjiang District from January 1, 2014 to December 31, 2024. Descriptive epidemiological methods were used to analyze the distribution of cases by person, time, and place. Joinpoint regression models were applied to examine trends for incidence and severe case rates, while seasonal patterns were analyzed using the seasonal index method. Chi-square tests were used for comparing rates, Mann-Whitney U tests were applied for comparing two groups with skewed distributions, and Kruskal-Wallis H rank-sum tests were used for multiple groups with skewed distributions. Pathogen characteristics were primarily analyzed using descriptive statistics. Results A total of 15,561 HFMD cases were reported from 2014 to 2024. The annual crude incidence rate ranged from 51.32/10⁵ to 502.50/10⁵, the age-standardized incidence rate ranged from 55.56/10⁵ to 721.07/10⁵, peaking in 2018, and the overall epidemic intensity generally showed an alternating-year pattern of intensification. A total of 85 severe cases were reported, showing a declining trend in severity rate (APC = AAPC = -37.57, P < 0.01). Severe cases were most common in the 1‑year‑old age group (43.53%), with a median age of 1.88 years old. Recurrent infections accounted for 1,245 cases (8.00%), with 96.73% of these being two-time infections. The median age at first infection for recurrent cases was 1.98 years old, significantly lower than that of single-infection cases (P < 0.001), and the median interval between consecutive infections was 1.19 years. The disease exhibited a bimodal seasonal pattern, with epidemic peaks occurring from May to July and from October to December, and however, summer peaks extending into autumn were observed in 2018 and 2023. There were statistically significant differences in age distribution across years (H = 467.51, P < 0.001), with the median age increasing from 2.25 years old in 2018 to 4.18 years old in 2024, and the interquartile range widening from 1.84 to 3.78 years. Pairwise comparisons revealed that the age distribution in the 2022-2023 group was significantly higher than in the 2014-2021 group (P < 0.05). Male incidence rates were consistently higher than female rates each year (P < 0.05). Pathogen analyses showed that CVA16 was detected annually, EV71 detection declined fluctuatingly and was not detected after 2022, and CVA6 was first detected in 2017 and was rapidly increased in prevalence and reached 87.50% in 2023, becoming the dominant strain. Among severe cases, EV71 accounted for the highest proportion (52.63%), while CVA16 was most common in non-severe cases (41.60%). There was a statistically significant difference in pathogen composition between severe and non-severe cases (P < 0.05). Conclusion The epidemiological profile of HFMD underwent continuous changes over time. It is necessary to strengthen routine surveillance, with particular attention to changes in the pathogen spectrum and age distribution, so as to provide evidence for precise prevention and control measures and the adjustment of vaccination strategies.