We characterized 515 Mycoplasma pneumoniae specimens in Hokkaido. In 2013 and 2014, the p1 gene type 1 strain, mostly macrolide-resistant, was dominant prevalence of macrolide resistance over 50 %. After 2017, 2 lineage, macrolide-sensitive, increased became 31.0 % 5.3 2018 16.3 2019.