The larval form of the fox tapeworm Echinococcus multilocularis can cause a potentially fatal liver infection in human hosts. Globally rare, the disease has a high prevalence focus in western China. Recent research has linked landscape to the presence and prevalence of the disease. This paper discusses the epidemiology of E. multilocularis in terms of landscape and disease transmission ecology. Landscape form was defined using satellite imagery to create a land cover classification for a study site in Zhang County (Gansu Province, China). Following the analysis of many landscape metrics, mean shape index was found to be related to the prevalence of infection for 31 villages in 1975 and 1997, at two spatial intervals, suggesting that habitat form is a correlate of disease. A temporal difference shows that the landscape is no longer suitable for transmission. These results indicate the possibility of identifying future hotspots which could aid the management of the disease.