Background <p>Brucellosis poses a significant public health challenge. This study aimed to analyze the epidemiological characteristics and spatiotemporal evolution of human brucellosis in Shanxi Province to inform targeted prevention strategies.</p> Methods <p>We obtained monthly and county-level human brucellosis case counts and incidence rates for Shanxi Province from 2014 to 2024 using China’s Disease Prevention and Control Information System. Joinpoint software was used to identify the temporal trends. ArcGIS was used for global Moran’s <i>I</i> to assess overall clustering, followed by Local Moran’s <i>I</i> to identify high-high and low-low clusters, and Getis-Ord <i>G</i>_<i>i</i>^* to detect hot and cold spots, and standard deviation ellipses to assess directional diffusion. The SaTScan was used to identify high-risk clusters.</p> Results <p>A total of 51,789 cases were reported, the age-standardized annual incidence rate was 10.4 per 100,000 (95% confidence interval [CI]: 8.4 per 100,000, 12.4 per 100,000) and the average annual percent change was − 5.00% (95% CI: -8.78%, -0.25%). A turning point in the incidence of the diseasewas observed in 2017, with peak incidence in May. Spatial analysis revealed significant clustering (Global Moran’s <i>I</i>: 0.307–0.498, all <i>P</i> &lt; 0.001) and the center shifting southwestward. Spatiotemporal scanning revealed the most likely clusters in northern Shanxi (<i>LLR</i>_2014-2015 = 3531.07, <i>LLR</i>_2019-2021 = 5111.36, <i>RR</i>_2014-2015 = 4.32, <i>RR</i>_2019-2021 = 4.89, <i>P</i> &lt; 0.001).</p> Conclusions <p>Human brucellosis in Shanxi has increased since 2017, with spatial diffusion from north to south and distinct seasonality. Enhanced surveillance and targeted interventions for high-risk populations and emerging disease hotspots are thus urgently required.</p>