Understanding occupational accident patterns is crucial for developing effective prevention strategies. Between 2019 and 2023, 383.644 occupational accidents involving immigrant workers were recorded in Spain, highlighting the need to analyze their distribution by economic sector and nationality. This study examines these patterns using official data from the National Institute for Occupational Safety and Health (INSST) and the Ministry of Inclusion, Social Security, and Migration. Findings reveal that accidents are particularly prevalent in construction, hospitality, and agriculture, where immigrants are overrepresented in hazardous jobs. Compared to native workers, they face higher accident rates due to precarious working conditions, limited safety training, and greater exposure to risks. These results underscore the necessity for sector-specific, nationality-targeted safety policies. The study emphasizes the importance of enhanced labor inspections, tailored training programs, and improved access to preventive measures. Limitations include potential underreporting and the absence of individual-level variables. Future research should adopt qualitative approaches to better understand migrant workers’ perceptions of occupational risks.