Background <p>The incidence of scrub typhus in China has consistently remained high, evolving into a significant public health concern. This study analyzed the epidemiological characteristics and temporal trends of scrub typhus in Ganzhou City from 2008 to 2021 at the township and subdistrict levels.</p> Methods <p>The distribution characteristics of scrub typhus were examined through three-dimensional trend surface analysis, spatial autocorrelation analysis, and spatio-temporal scanning. Moreover, the application of SARIMA models, BPNN models, and SARIMA-BPNN models for forecasting the number of scrub typhus offered a robust theoretical foundation for the prevention and control of this disease.</p> Results <p>A total of 5,942 cases of scrub typhus were reported in Ganzhou City from 2008 to 2021. The occurrence case was lower in males compared to females, with farmers being the main group affected. The age group most affected was 51–60 years. The disease showed strong seasonality, with the peak day of occurrence on 7 August and an epidemic period from 13 June to 2 October. Spatially, there was an aggregation of scrub typhus cases in Ganzhou City, particularly in the southeast and southwest regions. From 2013 to 2021, 132 high-high aggregation sites were identified. The SARIMA(1,0,0)(2,1,1)₁₂ model demonstrated superior performance compared to both the BPNN and SARIMA-BPNN models in forecasting trends in the number of scrub typhus cases.</p> Conclusions <p>Spatial and temporal clustering of scrub typhus occurrence in Ganzhou City at the township/street level was found from 2008 to 2021, primarily concentrated in the south. This highlights the need to enhance prevention and control measures in this area to effectively manage the scrub typhus epidemic. The SARIMA(1,0,0)(2,1,1)₁₂ model was better suited for capturing the reported occurrence changes of scrub typhus in the city.</p>