Abstract: OBJECTIVE To investigate the prevalence and epidemiological characteristics of infections with 7 types of respiratory pathogens in Sanya area so as to provide bases for control and prevention of respiratory tract infections. METHODS A total of 17 624 patients with suspected respiratory pathogens infections who were treated in Hainan Hospital, Chinese People's Liberation Army General Hospital from Nov. 2023 to Mar. 2025 were enrolled in the study, the results of real-time fluorescent PCR nucleic acid tests for 7 types of respiratory pathogens were retrospectively analyzed. The distribution of pathogens in the infection populations and seasons was observed. RESULTS The results of tests for 7 types of respiratory pathogens from the 17 624 patients showed that the positive rate of isolation was 44.26%, the positive rate of male patients was 43.29%, lower than 45.50% of the female patients(χ²=8.529,P=0.003). The influenza A virus (Flu A) and SARS-CoV-2 were the predominant pathogens, accounting for 12.18% and 11.51%, respectively. The patients with mixed infections accounted for 5.56%, the mixed infections of adenovirus (ADV) and Mycoplasma pneumoniae were most common (0.78%). In term of the age of the patients, the isolation rates of Flu A and respiratory syncytial virus (RSV) were respectively 13.04% and 9.26% among the patients aged between 0 and 7 years old; the incidence of M. pneumoniae infection reached the peak (21.08%) among the patients aged between 7 and 15 years old; the positive rate of SARS-CoV-2 was highest(19.48%) among the patients aged no less than 61 years old. Flu A was dominant among the outpatients (12.95%), and SARS-CoV-2 was dominant among the hospitalized patients (10.36%). In terms of seasonal distribution, the overall positive rate climbed to the peak in winter (January or February). A new round of peak of infection emerged with the successive outbreaks of Flu A, ADV, MP and SARS-CoV-2 infections. CONCLUSIONS The epidemiological characteristics of the respiratory tract pathogens are complex and diverse, and the pathogens vary in the seasons and susceptible populations. Therefore, it is necessary to develop targeted prevention strategies for the high-risk populations so as to meet the public health challenges.