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Author summary Visceral leishmaniasis (VL) remains a worldwide health issue, with increasing rates of mortality being observed. Brazil has an epidemiological scenario of expanding VL transmission, especially in the Northeast region. In the present study, we analysed spatiotemporal dynamics of VL cases and its association with social vulnerability in Brazilian Northeast. Briefly, data was analysed of all VL confirmed cases during the years of 2000 to 2017 and the Social Vulnerability Index (SVI) from 1,794 municipalities of Brazilian Northeast. Results revealed that VL continues to spread heterogeneously, with space-time high-risk clusters in the most socially vulnerable areas. We observed increasing trends of new cases among male subjects ≥ 40 years of age and urban residents. Our study represents the first investigation that demonstrates associations between VL and social vulnerability in the Northeast region of Brazil. These findings could contribute to VL prevention, surveillance