Cutaneous leishmaniasis (CL) is one of the most widespread neglected tropical diseases, transmitted by Phlebotomus sandflies and caused by protozoan parasites of the genus Leishmania. It poses a major global public health concern, particularly in arid and semi-arid regions where ecological and socio-environmental factors favor vector proliferation. In Algeria, CL is endemic across several regions, yet few studies have explored its long-term epidemiological dynamics in the Sahara Desert, where the disease continues to expand. This study aimed to investigate the spatio-temporal evolution and epidemiological characteristics of CL in the Sahara Desert of Algeria, specifically within the Djamaa province which represents an active and historically persistent focus of infection. Using a Bayesian analytical framework, we sought to identify demographic, temporal, and clinical determinants influencing disease occurrence and distribution, thereby providing insights for more effective control and prevention strategies. Data were obtained from the official public health records of the Djamaa province covering a 12-year period (2012-2023). Epidemiological variables included gender, age, number and anatomical site of lesions, and spatio-temporal case distribution across municipalities. Descriptive statistics and chi-square tests were applied to assess differences between groups. To account for uncertainty and the hierarchical structure of the data, a Bayesian Markov chain Monte Carlo Sampler for Multivariate Generalized Linear Mixed Model (MCMCglmm) was employed to evaluate the effects of temporal and clinical predictors on CL incidence. A total of 4436 confirmed CL cases were recorded during the study period, with a mean annual incidence of 369.7 cases. The highest peak was observed in 2012 (23.91%), followed by a gradual decline in subsequent years. Monthly distribution indicated pronounced seasonality, with maximum case occurrence in November (22.9%) and January (13.8%), reflecting the transmission dynamics of Phlebotomus vectors. CL affected both sexes and all age groups, but males (65.2%) and teenagers aged 10-20 years (33.7%) were the most affected, likely due to greater outdoor exposure. Lesions were mainly located on the lower extremities (64.9%), and multiple lesions were observed in 54% of patients. The Bayesian MCMCglmm analysis identified significant temporal effects (annual and monthly) and clinical variables (number and site of lesions) as major determinants shaping CL occurrence, confirming the strong seasonal and ecological dependence of the disease. The findings confirm that CL remains a major endemic health issue in the Sahara Desert of Algeria, particularly in Djamaa province. The disease exhibited clear temporal and demographic patterns linked to vector ecology and host exposure. To our knowledge, this is the first application of a Bayesian spatial model to characterize CL risk in the Northern Sahara of Algeria, this approach provided a robust framework for integrating uncertainty and multiple covariates, offering valuable evidence for risk-based vector control. Future research should combine epidemiological, entomological, molecular, and environmental analyses to develop an integrated strategy for CL management in hot arid lands.