An understanding of the geographic distribution of highly pathogenic avian influenza (HPAI) is essential to assessing and managing the risk of introduction of HPAI virus (HPAIV). However, to date, local spatial clustering patterns of HPAI outbreaks in Korea has not been explicitly investigated. We compiled HPAI outbreak data (n=622 cases) from December 2003 to February 2016. Each reported case was geocoded and linked to a digital map of Korea according to its onset location using the geographic information system (GIS). Kernel density estimation was used to explore global patterns of the HPAI outbreaks. We also applied the Getis-Ord G local spatial statistic to identify significant hot spots of high and low abundance by calculating Z-scores. Hot spot analysis revealed that HPAI cases are likely to be distinct clusters of HPAI outbreaks, with the highest risk being in the southwest of the country, specifically in Jeonnam and Jeonbuk provinces, where there are high density poultry populations. More than 16 Si-Gun-Gu (administrative province unit with bandwidth of 30 km) were involved in these high risk areas, indicating that there is likely to be a spatial heterogeneity of HPAI outbreaks within the country. Because of the existence of apparent hot spots, particularly in western regions, along with the increased number of migratory birds in these areas, Korea is at high risk of HPAIV introduction. Taking this challenge into consideration, preemptive and effective targeted surveillance programs for wild birds and poultry farms are highly recommended. Future research should look at the risk factors related to the socio-economic, human and natural environments and the poultry production systems to explain the spatial heterogeneity of HPAI outbreaks.