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Background: Disease trajectories have become increasingly relevant within the context of an aging population and the rising prevalence of chronic illnesses. Understanding the temporal progression of diseases is crucial for enhancing patient care, preventive measures, and effective management., Objective: The objective of this study is to propose and validate a novel methodology for trajectory impact analysis and interactive visualization of disease trajectories over a cohort of 71,849 patients., Methods: This article introduces an innovative comprehensive approach for analysis and interactive visualization of disease trajectories. First, Risk Increase (RI) index is defined that assesses the impact of the initial disease diagnosis on the development of subsequent illnesses. Secondly, visual graphics methods are used to represent cohort trajectories, ensuring a clear and semantically rich presentation that facilitates easy data interpretation., Results: The proposed approach is demonstrated over the disease trajectories of a cohort comprising 71,849 patients from Tolosaldea, Spain. The study finds several clinically relevant trajectories in this cohort, such as that after suffering a cerebral ischemic stroke, the probability of suffering dementia increases 10.77 times. The clinical relevance of the study outcomes have been assessed by an in-depth analysis conducted by expert clinicians. The identified disease trajectories are in agreement with the latest advancements in the field., Conclusion: The proposed approach for trajectory impact analysis and interactive visualization offers valuable graphs for the comprehensive study of disease trajectories for improved clinical decision-making. The simplicity and interpretability of our methods make them valuable approach for healthcare professionals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)