El Nino is a climatic cycle originating in the tropical Pacific Ocean that impacts the weather patterns of many countries in Latin America. It is often associated with water-based infectious disease epidemics, many of which are also poverty-related. The aim of this study was to explore ecosyndemic risk and factors of social vulnerability in Guatemala during the 2015-16 El Nino. Unlike an epidemic, which is centered on one disease, an ecosyndemic is a cluster of several infectious diseases within a population, associated with environmental changes, and often embedded within a wider context of social and economic inequities. Using geographic information systems (GIS) and multivariate analyses, this study examined 5 to 7 infectious diseases reported in Guatemala from 2014 to 2016 and social, economic and health factors of risk at the department-level. Preliminary results and policy implications will be discussed.