Characterizing longitudinal changes in region-specific distribution of environmental exposures, such as total nitrate (TNO$_3$) concentrations, is critical for understanding localized ecological risks that are otherwise obscured by standard mean-level modeling. However, modeling longitudinal distributional outcomes across spatial regions presents significant methodological challenges. The random objects are spatio-temporally dependent, and mathematical constraints are inherent to distributional representations, such as, monotonicity of quantile functions. To address this, we propose a novel spatially-indexed longitudinal distributional outcome regression model. The distributional coefficients corresponding to the fixed effects of covariates are modeled using Bernstein basis polynomials, while spatio-temporal random effects are flexibly captured via tensor product expansions of splines. We develop a scalable Markov Chain Monte Carlo (MCMC) algorithm to explicitly account for spatial dependencies, and introduce a fast two-stage projected-posterior approach to preserve the monotonicity of the predicted subject-specific quantile functions. Extensive simulation studies demonstrate that the proposed framework achieves superior estimation accuracy and predictive performance compared to standard non-spatial distributional outcome regression. We apply our methodology to predict monthly, site-specific distributions of TNO$_3$ concentrations across the contiguous United States. Accounting for spatial correlation provides substantially lower uncertainty in the estimated distributional effects and improves predictive performance over the non-spatial alternative, offering a robust, interpretable tool for spatio-temporal environmental monitoring.
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