Objective To analyze the clinical data of 48 monkeypox patients in Changsha City, improve the understanding and early diagnosis on monkeypox, and provide scientific basis for the prevention and control of monkeypox outbreak. Methods Clinical data of 48 monkeypox patients admitted to The First Hospital of Changsha City from June 29, 2023 to September 30, 2024 were collected retrospectively. Epidemiological data, clinical manifestations, diagnosis, and treatment process of patients were analyzed. Results All of the 48 patients were male, with a median age of 33 years old (19-54 years old). 95.83% (n=46) of the patients were men who had sex with men (MSM), and 93.75% (n=45) admitted to having sex with men prior to disease onset. Patients primarily presented with fever (43.75%) and rash (97.92%) as clinical manifestations, 62.50% (n=30) of the patients had concurrent human immunodeficiency virus (HIV) infection, and those with HIV infection had more severe skin rashes. After symptomaticand supportive treatment, most patients had good prognoses, but two HIV-infected patients died. Conclusion MSM are high-risk population for this monkeypox outbreak, and close contact is the main route of transmission. Patients present with fever and rash as major clinical manifestations. Monkeypox patients with concurrent HIV infection have more severe skin rashes. Most monkeypox patients have good prognoses, HIV co-infection and low CD4⁺T lymphocyte counts may be high-risk factors for death. Epidemic prevention and control should be carried out among high-risk population, and suspected rashes should be detected and treated as early as possible.