Abstract: OBJECTIVE To analyze the spectrum and epidemiological characteristics of 9 acute respiratory pathogens in a hospital in Dali Prefecture, providing a basis for diagnosis, treatment and prevention. METHODS Case data and serum specimens were collected from 34 745 outpatients and inpatients at Dali Bai Autonomous Prefecture People's Hospital from 2022 to 2024. Immunoglobulin M (IgM) antibodies against influenza A virus (FluA), influenza B virus (FluB), parainfluenza virus (PIV), adenovirus (ADV), respiratory syncytial virus (RSV), echovirus (ECHO), coxsackievirus B (CVB), Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP) were detected with magnetic particle chemiluminescence, followed by data analysis. RESULTS The overall positivity rate was 29.22% (10 152/34 745), with the highest rates observed for MP (17.28%), FluB (7.01%) and FluA (6.78%). The overall positivity rate increased from 22.33% in 2022 to 35.09% in 2024 (P＜ 0.001), peaking in autumn (35.43%) and winter (32.43%). The highest infection rate was in the 5-17 age group (44.45%), followed by the <5 age group (33.26%), with statistically significant differences (P＜ 0.05). Joinpoint analysis revealed that FluA, CVB, ADV, ECHO, RSV and MP were more prevalent in autumn and winteraverage annual percent change (AAPC) > 0, while FluB and PIV were common in summer (AAPC < 0). FluA, CVB and MP were concentrated in younger age groups with declining positivity trends (AAPC < 0), whereas FluB and PIV predominantly affected children and the elderly, showing a "decline followed by rise" trend (AAPC > 0). The co-infection rate was 7.16%, primarily dual infections (74.67%), with the most common combinations being FluA-MP (27.06%), FluA-PIV (20.10%) and FluA-RSV (10.66%). CONCLUSION The infection rates of the nine acute respiratory pathogens show an upward trend, with distinct differences in pathogens, seasons and ages, necessitating sustained surveillance and early warning.