Understanding the factors underlying the spatio-temporal distribution of infectious diseases provides useful information regarding their prevention and control. Dengue fever spatio-temporal patterns result from complex interactions between the virus, the host, and the vector. These interactions can be influenced by environmental conditions. Our objectives were to analyse dengue fever spatial distribution over New Caledonia during epidemic years, to identify some of the main underlying factors, and to predict the spatial evolution of dengue fever under changing climatic conditions, at the 2100 horizon. We used principal component analysis and support vector machines to analyse and model the influence of climate and socio-economic variables on the mean spatial distribution of 24,272 dengue cases reported from 1995 to 2012 in thirty-three communes of New Caledonia. We then modelled and estimated the future evolution of dengue incidence rates using a regional downscaling of future climate projections. The spatial distribution of dengue fever cases is highly heterogeneous. The variables most associated with this observed heterogeneity are the mean temperature, the mean number of people per premise, and the mean percentage of unemployed people, a variable highly correlated with people's way of life. Rainfall does not seem to play an important role in the spatial distribution of dengue cases during epidemics. By the end of the 21st century, if temperature increases by approximately 3°C, mean incidence rates during epidemics could double. In New Caledonia, a subtropical insular environment, both temperature and socio-economic conditions are influencing the spatial spread of dengue fever. Extension of this study to other countries worldwide should improve the knowledge about climate influence on dengue burden and about the complex interplay between different factors. This study presents a methodology that can be used as a step by step guide to model dengue spatial heterogeneity in other countries. Dengue fever is the most important viral arthropod-borne disease worldwide and its geographical expansion during the past decades has been of growing concern for scientists and public health authorities because of its heavy sanitary burden and economic impacts. In the absence of an effective vaccine, control is currently limited to vector-control measures. In this context, understanding the sociologic, entomologic and environmental factors underlying dengue dynamics is essential and can provide public health authorities with sound information about control measures to be implemented. In this study, we analyse socio-economic, climatic and epidemiological data to understand the impact of the studied factors on the spatial distribution of dengue cases during epidemic years in New Caledonia, a French island located in the South Pacific. We identify at risk areas, and find that temperature and people’s way of life are key factors determining the level of viral circulation in New Caledonia. Hence, communication campaigns fostering individual protection measures against mosquito bites could help reduce dengue burden in New Caledonia. Using projections of temperature under different scenarios of climate change, we find that dengue incidence rates during epidemics could double by the end of the century, with areas at low risk of dengue fever being highly affected in the future.