As a typical intangible cultural heritage, Toponymic Cultural Heritage (TCH) is rich in geographic information and semantic and physical connotations. In the context of the heritage conservation era, it is highly important to study the spatiotemporal distribution characteristics of toponymic cultural heritage and explore its historical and geographic influencing factors on the sustainable conservation and development of toponymic cultural heritage. However, most existing studies focus on the toponym cultural landscape, and less attention has been given to TCH. Therefore, on the basis of the data of 357 provincial TCH items in Jiangsu Province, this study investigated the spatiotemporal distribution characteristics and historical–geographical influencing factors of the TCH by using geospatial analysis methods, such as the average nearest neighbor, tyson polygon, kernel density estimation, standard deviational ellipse, and superposition coupling analysis, and proposed several strategies for adaptive reuse of TCH. The results show that (1) the TCHs of Jiangsu Province have a spatial distribution characteristic of "sparse in the north, scattered in the middle and dense in the south" and form a high-density agglomeration around the southern part of Jiangsu Province. In the distribution of cultural districts, the Jinling cultural district, the Wu cultural district, and the Huaiyang cultural district have the largest number of TCHs. (2) From the Pre-Qin period to the Ming and Qing Dynasties, TCHs, such as Nanjing, Yangzhou, Zhenjiang, Changzhou, and Suzhou, tended to merge in the southern part of Jiangsu. (3) In terms of type, the roads, streets and alleys of TCHs are the richest, and all types of TCHs are spatially clustered in the southern part of Jiangsu Province, which has a high level of urbanization, industrialization, and a superior geographic environment. (4) TCHs have spatial tendencies toward low altitudes and hydrophilicity, and relatively favorable natural geographical conditions provide a high-quality environment for TCHs in southern Jiangsu Province. Influenced by historical, humanistic, and geographical factors, TCH is unevenly developed spatially. As a historical population concentration area, an important political, economic, and cultural core area, and a center of gravity for cultural development, more TCH resources have survived in the southern part of Jiangsu Province. This study provides a new perspective for interpreting and recognizing TCH as a special intangible cultural heritage and can provide a reference for the sustainable conservation and development of TCH.