 The first COVID-19 case was reported in Ecuador on February 29, 2020. Since then, there have been 3,163 official cases and 120 deaths, resulting in a mortality rate of 3.8 percent. Spatial and spatio-temporal clusters of COVID-19 cases were identified in the Guayas province and the Pachincha province. The Guayas province had a relative risk of 7.08, while the Pachincha province had a relative risk of 0.38. These results suggest that the implementation of COVID-19 mitigation strategies should focus on areas of high transmission risk. This article was authored by Patricia Ballesteros, Emilie Salazar, Diana Sanchez, and others.