Millions of hand, foot and mouth disease cases occur annually and the disease is considered a significant public health threat in China. We have focused on Linyi for 3 years to analyse the aetiological spectrum and epidemic changes. The reported number of cases of HFMD in Linyi declined in 2011,with the percentage of HEV71 dropping to 11%. Although CVA16 rose to 51% in 2011, the number of CVA16 cases did not change significantly compared with the previous 2 years. Other types of enteroviruses were detected in 2011 and might play more important roles in future epidemics.