Lyme disease occurs commonly in New York State, but its geographic distribution is heterogeneous. Over each of nine consecutive years, incidence rates from 57 New York State counties were subjected to spatial autocorrelation analysis. Although the epidemic advanced during the study period, the analyses reveal a consistent pattern of spatial dependence. The correlation distance, the distance over which incidence rates covary positively, remained near 120 km over the nine years. A local spatial analysis around Westchester County, a major disease focus, indicated that the global correlation distance matched the extent of the most intense local clustering; statistically weaker clustering extended to 200 km from Westchester. Analyzing the spatial character of the epidemic may reveal the epizootic processes underlying patterns in human infection, and may help identify a spatial scale for regional control of disease.