Tinea capitis remains a common public health problem worldwide especially in developing areas. Aetiologic agents and clinical pattern vary with geography and history of socioeconomic conditions. Three community surveys and a prospective study were carried out over the past 50 years (1965-2014) in the Qingyunpu District of Nanchang, Southern China. Clinical presentation and spectrum of aetiological agents were monitored to understand the evolution of tinea capitis. In 1965 favus was highly epidemic and Trichophyton schoenleinii presented as the overwhelming aetiological agents of scalp infection in the study area, with a prevalence of 3.41% of the population. During a governmental campaign to eliminate tinea capitis initiated in mid of 1960s, favus was successfully controlled and the prevalence decreased to less than 0.01% in 1977. After that period, clinical presentation and spectrum of fungi changed with social development. Trichophyton schoenleinii was replaced by Trichophyton violaceum and Trichophyton mentagrophytes. Nowadays, the species corresponds with a dominant black dot type of tinea capitis in the Nanchang area. The prevalence of causative agents of tinea capitis is not only related to geography but also to socioeconomic factors. Multiple factors have to be considered for the management for control of this disease.