Objective To understand the respiratory pathogen infection of acute fever and respiratory symptoms in a hospital in Jinan City, explore its epidemiological characteristics, and provide reference for the scientific diagnosis and treatment of acute respiratory infection in this region. Methods Patients who underwent respiratory pathogen IgM antibody detection at Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2018 to June 2024 were selected as the research subjects. IgM antibody detection was performed on 9 common respiratory pathogens by magnetic particle chemiluminescence method. Pathogen detection of patients stratified by genders, age, season, and years was analyzed. Results A total of 19 463 patients were included in the analysis, out of which 6 933 patients were detected with at least one kind of pathogen, accounting for 35.62%. The top three pathogens with high detection rates were Mycoplasma pneumoniae (MP), influenza B virus (FluB), and influenza A virus (FluA), with detection rates of 17.14%, 13.62%, and 4.58%, respectively. The detection rates of single and multiple pathogens were 28.57% and 7.05%, respectively. The detection rate of females was higher than that of males (38.02% vs 33.78%), with statistically significant difference (P<0.001). With the increase of age, the total detection of respiratory pathogens first decreased, then increased. Detection rate of respiratory pathogens was highest in winter (41.59%) and lowest in autumn (31.23%). The total detection rate decreased year by year. Conclusion Respiratory pathogen infection in this region is mainly caused by MP and FluB, with minors being the high-risk population and winter being the peak season. In recent years, the detection rate has been decreasing year by year. Effort should be made to strengthen the prevention and treatment of high-risk populations during the peak season, so as to avoid large-scale regional epidemics.