Background. Acute respiratory infection (ARI) is one of the leading causes of morbidity among children under five in the developing world, including Nigeria. Objective. The study’s purpose is to analyze the geographical patterns, drivers and hotspots of ARI so as to provide a guide towards ARI interventions in Nigeria. Methods. Data for the study were obtained from the 2013 edition of the Nigerian Demographic and Health Survey (NDHS) report and the Annual Abstract of Statistics in Nigeria (2012). Spatial and statistical analyses were based on the local Getis Ord statistics and stepwise regression techniques. Results. There was substantial spatial variation in ARI prevalence, and significant hotspots were detected in Yobe, Jigawa, Kano, Bauchi, Gombe and Taraba states. The disease hotspots were attributed to one or more of the following: Boko Haram terrorism, prevailing dustladen north-east trade winds, and …