What are the socio-political consequences of infectious diseases? Humans have evolved to avoid disease and infection, resulting in a set of psychological mechanisms that promote disease-avoidance, referred to as the behavioral immune system (BIS). One manifestation of the BIS is the cautious avoidance of unfamiliar, foreign, or potentially contaminating stimuli. Specifically, when disease infection risk is salient or prevalent, authoritarian attitudes can emerge that seek to avoid and reject foreign outgroups while favoring homogenous, familiar ingroups. In the largest study conducted on the topic to date (N > 240,000), elevated regional levels of infectious pathogens were related to more authoritarian attitudes on three geographical levels: across U.S. metropolitan regions, U.S. states, and cross-culturally across 47 countries. The link between pathogen prevalence and authoritarian psychological dispositions predicted conservative voting behavior in the 2016 U.S. Presidential Election and more authoritarian governance and state laws, in which one group of people imposes asymmetrical laws on others in a hierarchical structure. Furthermore, cross-cultural analysis illustrated that the relationship between infectious diseases and authoritarianism was pronounced for infectious diseases that can be acquired from other humans (nonzoonotic), and does not generalize to other infectious diseases that can only be acquired from non-human species (zoonotic diseases). At a time of heightened awareness of infectious diseases, the current findings are important reminders that public health and ecology can have ramifications for socio-political attitudes by shaping how citizens vote and are governed.