Vacant houses can have a more serious impact on residents’ quality of life when they are spatially dense or when such conditions are fixated. Accordingly, this study examines the spatial clustering of vacant and abandoned houses and the fixation phenomenon in the clustered area through the case study of Iksan. The vacant and abandoned houses formed strong spatial clusters in the inner city of Iksan, and the clustered area showed characteristics such as physical vulnerability of housing and neighborhood environment, high percentage of elderly and low-income residents, and low real estate value. Also, in the clustered area, the vacant houses became more pronounced and multiplied as the occurrence diffused into adjacent areas. To draw the factors affecting the fixation of vacant houses, binary logistic regression was conducted and as a result, the characteristics of the parcels and location of those properties and the ratio of the elderly in the neighborhood present a statistically significant influence on fixation. The fixation process of vacant houses was found to occur in several vicious circles such as vulnerability of parcel and neighborhood environment, no transaction for long, difficulty in concluding a deal with owners, vulnerability of elderly owners, and indifference and helplessness of residents. This study shows implications for management and utilization of vacant houses in urban planning and suggests a useful analysis framework and strategies for the efficient management of vacant houses in small and medium-sized cities.