Background To prevent the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), strict control of person-to-person transmission is essential. Family transmission is the most common route of transmission; however, family transmission patterns and outcomes are not well understood. Methods We enrolled confirmed cases discharged from Wuhan Zhuankou Fangcang Shelter Hospital from February 17, 2020 to March 8, 2020 along with the family members they had contact with, to evaluate baseline characteristics, family transmission patterns and outcomes. The follow-up period lasted until May 8, 2020. Results This study evaluated 369 participants, which included 100 patients admitted to the shelter hospital and the family members they had contact with. Family transmission occurred in 62% of house-hold, with 190 cases confirmed to have SARS-CoV-2 infection. There were eight patterns of family transmission, and spousal transmission (44/83, 53.0%) was the most common pattern, especially in the middle-age generation group (35/83, 42.2%). The homes of the families in which all members were infected had a smaller per capita area than those of other families (29.1 +/- 11.89 cm(2) vs 41.0 +/- 19.70 cm(2), respec-tively, P = 0.037), and the per capita area was negatively associated with the number of infected family members (R = -0.097, P= 0.048). Of the 190 confirmed cases, the 113 mild or moderate cases were monitored in fangcang (including Wuhan Zhuankou Fangcang and other fangcang), and the 59 severe cases were treated at designated hospitals. By the end of follow-up, 185 patients recovered and returned home after completing at least 14 days of isolation at the community quarantine center, four died in hospitals, and one died at home before hospitalization. Interestingly, four patients had positive nucleic acid test results after previous negative results, though none of these patients were rehospitalized, and none of their close contacts reported an infection. Conclusions Our data found eight family transmission patterns, of which spousal transmission was the most common. Some patients were also found to have positive test results during follow-up.