Background <p>Animal bites are a significant public health concern, particularly in regions with high exposure to domestic and wild animals. Understanding their epidemiological patterns and determinants is essential for effective rabies prevention and control. This study aimed to investigate the epidemiological patterns and determinants of animal bites in urban and rural areas of Sarakhs County, Iran, from 2017 to 2024.</p> Methods <p>This cross-sectional descriptive-analytical study analyzed 6,371 recorded cases of animal bites reported to rabies prevention centers in Sarakhs County from 2017 to 2019. Data were collected using a census approach and extracted from the national portal system. Demographic and clinical variables were analyzed using SPSS v.26. Descriptive statistics and chi-square tests were employed to identify significant associations.</p> Results <p>The average annual incidence rate was 790.12 per 100,000 population. The majority of bite victims were male (78.8%), and most incidents occurred in the 20–49 age group (41.5%). Students constituted the most affected occupational group (28.1%). A large proportion of bites occurred in rural areas (84.4%), mainly during the spring season (27.2%), with a peak in May (9.5%). Dog bites accounted for 90.1% of all cases, and 95% of the biting animals were domestic. The most common site of injury was the lower limbs (57.3%), and in 43.2% of cases, the bites occurred in the afternoon hours. A statistically significant relationship was observed between the frequency of bites and variables such as age, sex, occupation, time of day, season, type of animal, and injury site (<i>p</i> &lt; 0.001).</p> Conclusion <p>Animal bites in Sarakhs County predominantly affect rural male students and are largely caused by domestic dogs. The findings highlight the need for targeted educational programs and preventive measures, especially in rural communities and among school-aged populations.</p>