Bacillary dysentery remains a major public health concern in China. The Beijing–Tianjin–Tangshan urban region is one of the most heavily infected areas in the country. This study aimed to analyze epidemiological features of bacillary dysentery, detect spatial-temporal clusters of the disease, and analyze risk factors that may affect bacillary dysentery incidence in the region. Bacillary dysentery case data from January 2011 to December 2011 in Beijing–Tianjin–Tangshan were used in this study. The epidemiological features of cases were characterized, then scan statistics were performed to detect spatial temporal clusters of bacillary dysentery. A spatial panel model was used to identify potential risk factors. There were a total of 28,765 cases of bacillary dysentery in 2011. The results of the analysis indicated that compared with other age groups, the highest incidence (473.75/105) occurred in individuals <5 years of age. The incidence in males (530.57/105) was higher compared with females (409.06/105). On a temporal basis, incidence increased rapidly starting in April. Peak incidence occurred in August (571.10/105). Analysis of the spatial distribution model revealed that factors such as population density, temperature, precipitation, and sunshine hours were positively associated with incidence rate. Per capita gross domestic product was negatively associated with disease incidence. Meteorological and socio-economic factors have affected the transmission of bacillary dysentery in the urban Beijing–Tianjin–Tangshan region of China. The success of bacillary dysentery prevention and control department strategies would benefit from giving more consideration to climate variations and local socio-economic conditions.