The economically important marine bivalve mollusc, Mercenaria mercenaria, (commonly called a northern quahog or hard clam), has endured considerable mortalities caused by a thraustochytrid pathogen called Quahog Parasite X (QPX). Data on the percent prevalence of QPX infections were compiled from published reports along with our data to describe the epizootiology of QPX disease. QPX infections occurred in clams collected from both cultured beds and wild populations, but a higher percentage of QPX cases (76.5%) were from cultured clam beds. In addition, samples from cultured beds had a significantly higher prevalence (29.2 ± 27.2%) of QPX infections compared with samples from wild populations (9.6 ± 9.6%). The highest prevalence of QPX infections occurred in clams from samples with an intermediate size range (shell lengths 20–55 mm). QPX infections occurred in both male and female clams, but infection prevalence does not appear to be correlated with sex or sex ratios. The geographical range of QPX-related clam mortalities was Atlantic Canada to the Eastern Shore of Virginia, USA. Only marginally significant differences were detected between the prevalence of QPX at different locations. There were no latitudinal gradients in QPX prevalence or frequencies, suggesting local factors were important in determining its distribution. Although QPX infections occurred throughout the year, no seasonal trends in the prevalence or frequencies of QPX were discernable. This summary of information available on QPX disease highlights the need for more thorough data collection regarding factors believed to be associated with its presence and severity in hard clams.