Objective To explore the disease spectrum and epidemiological characteristics in community residents in Dongfang city of Hainan province in 2021.Methods The medical records of 196 761 community residents in 2021 were collected from the disease surveillance database of Dongfang city of Hainan province.The top ten diseases with high age-standardized prevalence rate were analyzed.Results Of 196 761 community residents,91 621(46.56% )were males and 105 140(53.43% )were females,with a male-to-female ratio of 0.87;the majority of residents were aged≥45 years,accounting for 46.13% of all residents(90 763/196 761).The top three diseases in the disease spectrum were respiratory diseases[32.69% (64 327/196 761)],circulatory diseases[7.86% (15 470/196 761)]and digestive diseases[7.21% (14 191/196 761)].Among the top 10 diseases,the age-standardized prevalence of injuries,poisonings and other conditions caused by external causes was higher in men than that in women(3.11% vs 2.30% ),while the age-standardized prevalence of genitourinary system diseases was higher in women than that in men(3.01% vs 1.20% ).The respiratory diseases were dominated by acute upper respiratory tract infections(5.17% ),acute bronchitis(1.84% )and chronic bronchitis(1.44% ),with the highest prevalence(38.59% )and years lived with disability rate(656.01/105)in the age group<5 years;the circulatory diseases were dominated by hypertension(1.72% ),cerebral infarction(0.71% ),and chronic ischemic heart disease(0.49% ),with the highest prevalence(17.13% )and years lived with disability rate(2 175.49/105)in the age group ≥60 years;the digestive diseases were dominated by gastritis and duodenitis(1.10% ),other non-infectious gastroenteritis and colitis(0.43% ),and gingivitis and periodontal diseases(0.38% ),with the highest prevalence(6.98% )and years lived with disability rate(1 710.75/105)in the age group ≥60 years.Conclusion The community residents in Dongfang city of Hainan province in 2021,mainly suffer from respiratory diseases,circulatory diseases and digestive diseases,and the disease burden is mainly attributed to diseases that require long-term management.