Background <p>The prevention and control of infectious diseases have become a critical issue in public health, especially after COVID-19. Typhoid and paratyphoid fevers continue to pose a threat, with outbreaks still occurring in many parts of the world, including certain regions of China. The aim of this study was to analyze the incidence trends and epidemiological characteristics of typhoid and paratyphoid fevers in China from 2014 to 2022, to delineate the evolving epidemiological characteristics and spatiotemporal patterns, thereby informing evidence-based prevention and control strategies.</p> Methods <p>Data on typhoid and paratyphoid cases were obtained from the Public Health Science Data Center of the Chinese Center for Disease Control and Prevention and the China Health Statistics Yearbook and demographic data from the National Bureau of Statistics. Joinpoint 5.3.0 and R 4.4.1 software were applied for temporal trend and seasonal analysis, while spatial autocorrelation and clustering analysis were performed using ArcGIS 10.2 software.</p> Results <p>From 2014 to 2022, a total of 67,252 cases of typhoid were reported nationwide. The incidence rate decreased from 0.76/100,000 in 2014 to 0.33/100,000 in 2022, with Joinpoint regression analysis showing an annual percentage change (APC) of -9.57% (<i>P</i> &lt; 0.001). The proportion of cases in the 0-4 and ≥ 60 age groups showed an increasing trend, rising from 12.12% and 15.36% in 2014 to 23.17% and 19.10% in 2022, respectively. The composition ratio of scattered children increased from 13.04% in 2014 to 20.55% in 2022. The highest incidence rate was observed in the 0-4 age group, ranging from 1.42/100,000 to 1.87/100,000. High-incidence provinces for typhoid included Yunnan, Guangxi, Guizhou, and Guangdong Province. During the same period, 20,044 paratyphoid cases were reported nationwide, with the incidence rate decreasing from 0.24/100,000 in 2014 to 0.09/100,000 in 2022. Joinpoint regression analysis showed an APC of -9.54% (<i>P</i> = 0.001). The proportion of cases in the 0-4 and ≥ 60 age groups increased from 13.00% and 11.09% in 2014 to 40.08% and 23.31% in 2022, respectively. The composition ratio of scattered children increased from 13.12% in 2014 to 38.26% in 2022. The highest incidence rate was observed in the 0-4 age group, ranging from 0.55/100,000 to 0.91/100,000, showing a fluctuating upward trend. High-incidence provinces for paratyphoid included Yunnan, Guangxi, Guizhou, Hainan and Guangdong Province.</p> Conclusion <p>Typhoid and paratyphoid fever in China continue to exhibit low-level endemicity, with incidence rates declining in recent years. Special attention should be paid to the rising incidence in the 0-4 age group and the increasing proportion of cases among individuals aged ≥ 60 years. High-incidence provinces are primarily concentrated in Yunnan, Guangxi, Guizhou, Guangdong, and Hainan Province.</p> Clinical trial number <p>Not applicable.</p>