Objective The objective is to reveal the epidemiological burden and predictors of acute gastroenteritis in Heilongjiang Province. Methods A multi-stage stratified random sampling method was used to collect the incidence of acute gastroenteritis in the past 4 weeks. Results A total of 19 171 people were investigated. The monthly prevalence of acute gastroenteritis was 3.51% [95% confidence interval(95%CI):3.25%-3.77%], the annual incidence rate was 37.24%, and the incidence rate was 0.466 times per person-year. The weighted monthly prevalence rate was 3.61%, the weighted annual incidence rate was 38.07%, and the weighted incidence rate was 0.479 times per person-year. It was estimated that the average annual incidence of acute gastroenteritis in this province was 14.423 million people per year, with a total of 18.147 million cases. Multivariate Logistic regression analysis showed that the nature of the residence, season, age, whether they had left their residence due to business or trips in the past 2 weeks, and the annual per capita income of the family were the influencing factors.58.66% of acute gastroenteritis cases were attributed to contaminated food. Conclusion Acute gastroenteritis in Heilongjiang Province had a heavy epidemiological burden and a high proportion of foodborne diseases, which should be paid more attention to.