With the advancement of “targeted poverty alleviation”, the main problems we face at this stage are analyzing the causes of poverty and preventing poverty-stricken villages from falling back into poverty. Using the last batch of poverty-stricken villages that have been lifted out of poverty, which were announced by the Henan Provincial poverty alleviation and development office, as the research object, this research discusses the spatial distribution characteristics of 835 poverty-stricken villages in Henan Province from the perspective of the macro province by combining kernel density analysis and spatial autocorrelation analysis, analyzes their influencing factors using the least squares linear regression model, and performs a quantitative analysis of their influencing factors. The results revealed the following: (1) The spatial distribution characteristics of poverty-stricken villages in Henan Province are characterized by significant agglomeration. A banded high-density area is formed in the east of Henan Province, with a sub-density area in the west of Henan Province, and it radiates outward with the “dikaryon” as its center. (2) High-density and sub-density areas of poverty-stricken villages are mainly located in flat areas, with spatial dependence on each other. The high-high clustering areas are mainly areas dominated by agricultural economies. The low-low clustering areas mainly have limited agricultural development and rapid urban–rural integration. (3) Geographical locations and socio-economic and basic public services are the main factors affecting poverty in poverty-stricken villages. At the same time, environmental livability is an advantageous condition in areas where poverty-stricken villages are located, of which the Temperature Humidity Index factor is most closely related to the distribution density of poverty-stricken areas. The research results are intended to provide information for the policies and program intervention strategies for poverty reduction and sustainable development in poverty-stricken villages in Henan Province, and this is conducive to consolidating the results of targeted poverty alleviation and preventing a return to poverty.