Objective To analyze the pathogenic spectrum of influenza-like illness (ILI) in Luohe region in 2025. Methods A total of 751 ILI throat swab samples were collected from Luohe Central Hospital from January to December 2025. The national multipathogen nucleic acid detection kit for acute respiratory infectious diseases was used to simultaneously detect 18 respiratory-related pathogen targets (more than 13 categories), and epidemiological analysis was conducted. Results The overall positive rate was 82.56% (620/751), with 1, 058 pathogen strains detected. The nucleic acid positivity rates were highest for Haemophilus influenzae (40.61%), Influenza A H3N2 (24.37%), and Streptococcus pneumoniae (24.10%). Mycoplasma pneumoniaeand Bordetella pertussis were not detected. The co-infection rate reached 64.35% (399/620), predominantly the“ Influenza A＋bacteria” pattern. Seasonal analysis revealed that Influenza A H3N2 peaked in Q4 (October-December) with a positivity rate of 77.87%, while rhinovirus peaked in Q4 (27.66%). Haemophilus influenzae and Streptococcus pneumoniae maintained high baseline carriage rates throughout the year. The distribution differences of each major pathogen in different quarters were all statistically significant (all P＜0.05). Conclusion ILI in Luohe region in 2025 exhibited a co-epidemic pattern of viruses and bacteria. Given the high nucleic acid detection rates of Haemophilus influenzae and Streptococcus pneumoniae, they should be regarded as important epidemiological burden markers in ILI surveillance rather than direct evidence of clinical infection.