Significant carbon emissions, a key contributor to global climate warming, pose risks to ecosystems and human living conditions. It is crucial to monitor the spatial and temporal patterns of carbon emissions at the county level to reach the goals of carbon peak and neutrality. This study examines carbon emissions and economic and social problems data from 89 counties in Zhejiang Province. It employs analytical techniques such as LISA time path, spatio-temporal transition, and standard deviational ellipse to investigate the trends of carbon emissions from 2002 to 2022. Furthermore, it utilizes the GTWR model to evaluate the factors that influence these emissions on a county scale. The findings reveal the following: (1) The LISA time path analysis indicates a pronounced local spatial structure in the distribution of carbon emissions in Zhejiang Province from 2002 to 2022, characterized by increasing stability, notable path dependency, and some degree of spatial integration, albeit with a diminishing trend in overall integration. (2) The LISA spatio-temporal transition analysis indicates significant path dependency or lock-in effects in the county-level spatial clustering of carbon emissions. (3) Over the period 2002–2022, the centroid of carbon emissions in Zhejiang’s counties mainly oscillated between 120°55′15″ E and 120°57′01″ E and between 29°55′52″ N and 29°59′11″ N, with a general northeastward shift forming a “V” pattern. This shift resulted in a stable “northeast–southwest” spatial distribution. (4) Factors such as population size, urbanization rate, and economic development level predominantly accelerate carbon emissions, whereas industrial structure tends to curb them. It is crucial to customize carbon mitigation plans to suit the circumstances of each county. This study provides insight into the spatial and temporal patterns of carbon emissions at the county level in Zhejiang Province. It offers crucial guidance for developing targeted and practical strategies to reduce carbon emissions.