Despite being considered a neglected, re-emerging and the most widespread zoonotic disease worldwide, human-dog leptospirosis has not been subjected to One Health approach, and neither were its socioeconomic and environmental risk factors, as well as concomitant spatial analysis over time. Accordingly, notified human leptospirosis cases, incidence rate and urban hotspot areas, in addition to a systematic review of dog leptospirosis cases, were performed nationwide from 2001 to 2020 in Brazil. Data on Gross Domestic Product (GDP), flooding and study areas were also assessed and tabulated. Human–dog leptospirosis cases were simultaneously mapped with overlapping flooding areas, along with the main circulant serovars. Comparative outcome has shown that dogs may be exposed similarly to humans, becoming important sentinels and/or reservoirs for human leptospirosis in larger geographic areas. Moreover, the study herein can help in the decision and implementation of public policies in Brazil and may serve as a model for other tropical countries worldwide.