This study analyzes the characteristics of one of the main foci for cutaneous leishmaniasis transmission in the city of Rio de Janeiro, Brazil, examining its territorial configuration and the relations with spatial organization processes. An analytical model was applied to the process of occupation and organization of urban space on a local scale, considering the new functions acquired by the spatial elements expressed by different work relations, land use, and land value. The study employed geoprocessing techniques and classification of images obtained by remote sensing, localization of households, and cases of cutaneous leishmaniasis, associated with qualitative data on the historical process of land occupation and use. The analysis detected areas with distinct conditions of vulnerability and showed that changes in these conditions allowed production of the epidemic in a given time period and its subsequent reduction. The study contributes to monitoring of the disease at the local level and application of effective measures for cutaneous leishmaniasis surveillance and control.