Famous Historical and Cultural Towns or Villages are among the important components of China’s cultural heritage. Their spatial distribution patterns are directly related to regional geographical patterns, historical transportation geography and traditional communities. Meanwhile, their conservation is challenged by the change in regional population density, the level of urbanization, modern transportation and ecological environment conditions. Therefore, studying the provincial distribution patterns is of great practical significance to the conservation and sustainable development of Famous Historical and Cultural Towns or Villages in China. This study takes 44 of China’s national and provincial Famous Historical and Cultural Towns or Villages in Hubei Province that were announced from 2003 to 2022 as the research subjects and uses the Geographic Information Technology (GIS) tools to determine their clusters and linear distribution zones, including nearest distance analysis, nuclear density analysis, buffer zone analysis and imbalance index analysis. We further analyze the causes of their spatial distribution in conjugation with historical geography and factors related to the preservation of the current situation of them via correlation analysis. Finally, we make suggestions for the conservation and development of Famous Historical and Cultural Towns or Villages in Hubei Province.