〔Abstract〕 Objective To analyze the epidemiological characteristics and pathogen composition of hand-foot-mouth disease (HFMD) in Meizhou city from 2018 to 2020, and to provide reference for effective prevention and control measures. Methods HFMD patients reported by the Disease Surveillance Information Reporting System in Mezhou city from January 2018 to December 2020 were selected for detection. Throat and anal swab samples were collected and nucleic acid test results of enterovirus 71 (EV71), Coxsackie virus A16 (CA16) and Coxsackie virus A6 (CA6) were analyzed. Results A total of 660 HFMD patients were reported in Meizhou city from 2018 to 2020, with an average annual incidence of 15/100,000. In 2019, the number of patients was the most, with an incidence rate of 8.1/100,000. The number of cases in the first quarter was the lowest, 26 cases in total, accounting for 3.94% of the total patients. The peak of incidence was concentrated in June and July, 233 cases, accounting for 35.30% of the total. The third quarter was the most serious, with 286 cases, accounting for 43.33% of the total number of patients. The number of patients under 6 years old was 636, accounting for 96.36% of the total number of patients. The number of patients under 0 ~ 3 years old was 558, accounting for 84.55% of the total number of patients. Among them, the number of patients under 1 year old was the most 265, accounting for 40.15% of the total number of patients. EV71 positive cases, CA16 positive cases, CA6 positive cases and other enterovirus positive cases were 6, 184, 297 and 95 respectively, accounting for 0.91%, 27.88%, 45.00% and 14.39% of the total number, respectively. The number of EV71 positive people, CA16 positive people and other enterovirus positive people decreased year by year, and the number of CA6 positive people was the highest in 2019. Conclusion The incidence of HFMD in Meizhou city has obvious age, seasonal and population differences, and CA16 and CA6 are the main pathogens. It is necessary to pay more attention to the change of HFMD pathogen spectrum, and take comprehensive prevention and control measures for key population to reduce the outbreak of HFMD.