Leptospirosis is an important health problem in Indonesia, with most cases found in East Java and Central Java provinces. This study aims to identify the distribution pattern of leptospirosis in the two provinces using a clustering approach. The Density-Based Spatial Clustering of Applications with Noise (DBSCAN) method is used to cluster areas based on leptospirosis spread factors, but DBSCAN requires optimal parameter determination for accurate results. Therefore, this research implements Flower Pollination Algorithm (FPA) to optimize the epsilon (ϵ) and minimum points (MinPts) parameters in DBSCAN. This research uses secondary data obtained from data on the Number of Natural Disaster Events by Regency / City in East Java and Central Java Provinces in 2023 and data on Population Density by Regency / City in East Java and Central Java Provinces in 2023. The population in this study uses all observations, namely all people in the districts and cities in East Java and Central Java. The sampling technique is saturated sampling, that is, the entire population in the study is sampled. The clustering results using FPA-DBSCAN resulted in two main clusters, with 30 districts/municipalities detected as noise, 23 districts/municipalities belonging to cluster 0, and 20 districts/municipalities in cluster 1. The validation test using Silhouette Coefficient showed a value of 0.1892, indicating that the clustering is quite valid. The results of this clustering can serve as a strategic reference for local governments in optimizing disease surveillance and targeted health interventions.