Introduction: Typical response to dengue fever cases is the fogging activity to target the adult mosquito population. This process must be performed at a time period coinciding with the mosquito life cycle. However, there is no evi- dence to confirm the efficacy of fogging in preventing mosquito bites, and this study would examine the connection between the incidence of fogging in Sandakan and the number of dengue cases recorded. Materials and Methods: Dengue surveillance data were derived from the e-Dengue database system (version 2.0). This analysis looked at the fogging level of every locality in 15 zones and at the incidences of dengue in Sandakan. We collected the data from Sandakan Health District Office. The operation data has been combined with each location. The level of fogging was dependent on the amount of region affected and the year, which was then converted to monthly results. Data was obtained using a regression analysis, and analyzed. Results: Results indicate that the frequency of fogging increases with dengue cases. A statistical result shows that more fogging activities resulted in greater numbers of dengue cases. A correlation coefficient of 0.75 suggests the frequency of fogging and the incidence of dengue fever are positively correlated. Conclusion: Overall, there is a linear pattern of positive data association. This result shows that the higher the fogging frequency, the higher the incidence of dengue fever.