To investigate the impact of the El Ni–o Southern Oscillation (ENSO) on dysentery transmission, the relationship between monthly dysentery cases in Shandong Province of China and the monthly Southern Oscillation Index (SOI), a broad index of ENSO, was examined over the period 1991-2003. Spearman correlations and generalized linear models were calculated to detect the association between the SOI and dysentery cases. Data from 1991 to 2001 were used to estimate the parameters, while data from 2002 to 2003 were used to test the forecasting ability of the model. After controlling for seasonality, autocorrelation, and a time-lagged effect, the results indicate that there was a significant negative association between the number of dysentery cases and the SOI, with a lagged effect of 2 months. A one-standard-deviation decrease in the SOI might cause up to 207 more dysentery cases per month in Shandong Province. This is the first report of the impact of the Southern Oscillation on dysentery risk in China, indicating that the SOI may be a useful early indicator of potential dysentery risk in Shandong Province. © 2006 Elsevier Inc. All rights reserved.