Background/Aim: Acute Diarrhoeal disease (ADD) has a significant impact on public health and is the most common cause of mortality and morbidity. The present study attempts to study the spatiotemporal distribution of incidences of ADD and also tries to identify the geographical risk factors by associating socioeconomic and environmental factors with the prevalence of ADD. MethodsThis cross-sectional study conducted micro-level analysis in 24 randomly chosen villages, representing 5% of Ladakh's medical blocks, to gather household data on diarrhoeal diseases, encompassing demographic, socio-economic, and residential environmental factors. Our dataset combines primary and secondary data. We utilized binary logistic regression to evaluate associations between these factors and diarrhoeal disease prevalence. ResultsSpatio-temporal analysis in Ladakh's medical blocks revealed significant variations in diarrhoeal disease incidence, with Leh district showing higher rates compared to Kargil. The under-14 age group exhibited the highest ADD incidence (163.46 per 1000 persons), followed by the over-59 age group (43.73) and the 14-59 age group (8.90), with an overall prevalence rate of 38.91 per 1000 population. Factors such as education levels, household income, sewage drainage facilities, residential environment, and drinking water sources showed statistically significant associations with diarrhoea prevalence among surveyed households of Ladakh. ConclusionsThis research highlights the importance of addressing environmental and socio-economic determinants to mitigate the burden of diarrhoeal diseases in Ladakh. Effective interventions targeting improved sanitation, access to clean water, and socio-economic development are crucial for reducing diarrhoeal disease prevalence in the region.