The pattern of health spending in Indonesian regions during 2017–2024 reflects the strong impact of the COVID-19 pandemic on regional fiscal priorities and public health financing. Average health expenditure increased gradually from 14.53% in 2017 to 15.63% in 2019, before declining to 10.63% in 2020 during the early phase of the pandemic, likely due to rapid budget refocusing and emergency fiscal adjustments. However, health spending surged sharply to 18.76% in 2021 as regional governments intensified spending on healthcare facilities, medical equipment, and pandemic response programs, before stabilizing at around 16.8% during 2022–2023. The sharp decline to 7.29% in 2024 likely reflects incomplete fiscal reporting rather than an actual reduction in healthcare priorities. Significant regional disparities also emerged, with urban municipalities such as Cirebon (34.89%), Sukabumi (32.64%), and Pare-Pare (29.82%) allocating substantially larger shares of their budgets toward health expenditure, indicating stronger emphasis on healthcare infrastructure and public health services. Moreover, the distribution of spending shows that most regions allocated between 10% and 20% of total expenditure to health, although several outliers consistently recorded much higher spending shares due to region-specific healthcare demands and policy priorities.