Bétaré-Oya is one of the gold mining districts in the eastern region of Cameroon. Structural controls on gold mineralization were examined along the Bétaré-Oya Shear Zone, providing further clues on favorable areas for mineral exploration. GIS-based methods combining point pattern (i.e., quadrat count, Fry analysis) and distance distribution analysis were employed here to delineate the spatial patterns of known gold deposits and to evaluate their spatial association with geological structures. Results show that the gold deposits in this area are spatially clustered. At the regional scale, the Fry plot indicates an alignment of deposits, suggesting that gold mineralization is controlled by structures oriented NNE–SSW and NE–SW. At the deposit scale, an alignment is also evident, indicating that the mineralization is also controlled by ENE–WSW-trending structures. The cumulative relative frequency distribution of distances from lineament features to gold occurrence points (D_M) and to non-occurrence points (D_N) ratio (D_M/D_N) was used to rank these two major structural trends and their relative importance as mineralization control. The yielded grades show that NE–SW-trending lineaments, akin to P-type structures, play a major role in controlling the gold mineralization in the area compared to other structures. Beyond the goal to foster mineral prospection in the Bétaré-Oya gold district, information yielded in the present study provides relevant criteria for further exploration in the eastern region of Cameroon.