Recent technological advances have enabled spatially resolved measurements of expression profiles for hundreds to thousands of genes in fixed tissues at single-cell resolution. However, scalable computational analysis methods able to take into consideration the inherent 3D spatial organization of cell types and non-uniform cellular densities within tissues are still lacking. To address this, we developed MERINGUE, a computational framework based on spatial auto-correlation and cross-correlation analysis to identify genes with spatially heterogeneous expression patterns, infer putative cell-cell communication, and perform spatially informed cell clustering in 2D and 3D in a density-agnostic manner using spatially resolved transcriptomics data. We applied MERINGUE to a variety of spatially resolved transcriptomics datasets including multiplexed error-robust fluorescence in situ hybridization (MERFISH), spatial transcriptomics, Slide-Seq, and aligned in situ hybridization (ISH) data. We anticipate that such statistical analysis of spatially resolved transcriptomics data will facilitate our understanding of the interplay between cell state and spatial organization in tissue development and disease. Cold Spring Harbor Laboratory Press on May 30, 2021 -Published by genome.cshlp.org Downloaded from tissue, thereby losing valuable spatial context (Crosetto et al. 2015). Thus, how these subpopulations of cells are organized in space and how they may interact with each other remains an open question in many systems.To preserve informative spatial context, recent advances in imaging-based approaches have enabled in situ, spatially resolved transcriptomic profiling with single-cell resolution (Zhuang 2021). In addition, approaches based on spatially resolved RNA capture followed by sequencing, such as spatial transcriptomics and Slide-seq provide spatially resolved, untargeted transcriptomic profiling at the pixel level, with pixel size of 10-100µm (Larsson et al. 2021). Such high throughput data generation, both in terms of the number of genes and number of cells assayed, demands scalable computational methods that take advantage of this new spatial dimension to efficiently identify statistically significant spatial patterns and relationships. In addition, as these methods are applied to increasingly complex tissues, statistical analyses must be able to accommodate the non-uniform cell density induced by biological factors, such as the presence of multiple, often spatially organized, cell-types inherent to tissues, as well as technical factors, such as distortions from tissue sectioning.Three statistical methods, SpatialDE, Trendsceek, and SPARK have previously been developed to identify spatial gene expression heterogeneity, defined as an uneven, aggregated or patterned, spatial distribution of gene expression magnitudes (Svensson et al. 2018;Edsgärd et al. 2018;Sun et al. 2020).Briefly, SpatialDE identifies spatial gene expression heterogeneity by decomposing a gene's expression variance into a spatial and a non-spatial c...