Objective To analyze the detection results of serum immunoglobulin M (IgM) antibodies against eight respiratory pathogens, and to investigate the pathogen distribution characteristics in patients with acute respiratory infection-related symptoms in the local region, thereby providing reference for clinical diagnosis and treatment as well as surveillance of key populations. Methods A retrospective analysis was conducted on the IgM test data for respiratory pathogens from patients admitted to People’s Hospital of Ningxia Hui Autonomous Region between January and December 2024. Patients of different genders, age groups, and months were analyzed and compared. Results A total of 9473 patients were included. Among them, there were 5006 males (52.84%) and 4467 females (47.16%). The overall detection rate of respiratory pathogens was 45.38% (4 299/9 473). Mycoplasma pneumoniae (MP) IgM showed the highest positivity rate (26.89%), followed by influenza A virus (Flu A) (10.01%) and respiratory syncytial virus (RSV) (6.15%). The IgM positivity rates for MP and Chlamydia pneumoniae (CP) were significantly higher in female patients than in males (P<0.05). Significant differences in IgM detection rates were observed across different age groups for Flu A, influenza B virus, adenovirus, coxsackievirus B, RSV, MP, and CP (P<0.05). The MP detection rate decreased with increasing age, while Flu A infection primarily affected individuals aged 45 years and older. In terms of temporal distribution, higher positivity rates for respiratory pathogens were mainly observed from April to December. The MP IgM positivity rate remained consistently higher than that of other pathogens from March to November, whereas Flu A IgM positivity rates peaked in January and December. Conclusions The predominant respiratory pathogens are MP, Flu A, and RSV, a profile consistent with the overall national trend. The distribution of some pathogens varies by gender, age and time.