Effective surveillance of respiratory infectious diseases is crucial for precise prevention and evidence-based public health response. This study analyzed the etiological spectrum of respiratory pathogens in Zhuhai, a high-mobility port city, from January 2024 to December 2025. Throat swab specimens from national sentinel influenza-like illness (ILI) cases and hospitalized severe acute respiratory infection (SARI) cases were tested for 22 pathogens using real-time PCR. Descriptive epidemiological methods were applied. Among 2,788 patients, the overall pathogen positivity rate was 64.56