Objective To investigate the distribution characteristics of TCM syndrome types in hand, foot and mouth disease and related influencing factors. Methods The clinical data of 298 children with hand, foot and mouth disease who were diagnosed with the four diagnostic methods in traditional Chinese medicine (TCM) were collected to analyze the distribution characteristics of TCM syndrome types and their association with sex, age, course of the disease, and major laboratory markers. Results In the 298 children with hand, foot and mouth disease, the most common TCM syndrome type was stagnation and steaming of damp-heat, followed by the syndrome of damp-heat of lung and spleen and the syndrome of stirring wind due to toxic heat. There were significant differences in sex and course of the disease between the children with the three syndrome types (P<0.05). The syndrome of stirring wind due to toxic heat was commonly seen in boys. The syndrome of damp-heat of lung and spleen was commonly seen at 5-6 days after onset, the syndrome of stagnation and steaming of damp-heat was commonly seen at 5-7 days after onset, and the syndrome of stirring wind due to toxic heat was commonly seen at 7-8 days after onset. There was no significant difference in age between the children with the three syndrome types (P>0.05). There was a significant difference in the type of pathogen between the children with the three syndrome types (P<0.05); the children with the syndrome of damp-heat of lung and spleen were mainly infected with coxsackie virus A-16, while those with the syndromes of stagnation and steaming of damp-heat and stirring wind due to toxic heat were mainly infected with enter ovirus 71. Compared with those with the syndromes of damp-heat of lung and spleen and stagnation and steaming of damp-heat, the children with the syndrome of stirring wind due to toxic heat had significantly higher leukocyte count and levels of blood glucose, creatine kinase-MB, serum interleukin-6, procalcitonin, and C-reactive protein (P<0.05). Conclusion The distribution of TCM syndrome types of hand, foot and mouth disease have certain characteristics, which are significantly associated with sex, course of the disease, and major laboratory markers.