This study aims to analyze the spatial distribution of waterborne and foodborne diseases in the health regions of Rio Grande do Sul and its correlation with sanitary and socioeconomic characteristics. It is an ecological study with multiple groups, using statewide secondary data from 2018 to 2021, considering the average hospitalization and mortality rates as dependent variables, and sanitary and socioeconomic indicators as independent variables. Spatial dependence was observed for morbidity and mortality, with lower values in the more developed regions of the state. Negative associations between hospitalization and mortality rates were common with total water supply, sewage, and coverage of household solid waste collection services. A positive association was found between hospitalization rates and the Gini coefficient. The high morbidity and mortality in specific regions, in conjunction with sanitary and socioeconomic indicators, highlight priority areas for public policies ensuring the right to water and sanitation for the people of Rio Grande do Sul.