Large temperature drops between neighbouring days had an adverse effect on childhood HFMD. However, non-significant association between DTR and childhood HFMD was observed. Additionally, male children, children aged 0–5 years, scattered children and children in high-risk areas showed more sensitive to TCN effect. As climate change continues, more effective strategies to protect children from being harmed by TCN impacts are needed. This study also indicates that temperature change between neighbouring days may be an alternative temperature indicator for studying temperature-HFMD relationship.