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Garbage collector is a high-risk job, with exposure to a variety of occupational and non-occupational factors. Total injury rates of occupational accidents in these workers are not known in Paraguay, the aim of the study was to estimate and to compare the prevalence of accidents at work in formal and informal garbage collectors of Asunción, Paraguay.A cross-sectional study was conducted among 186 formal and 123 informal garbage collectors (response 84.5%, 56%). The 12-months-prevalence of occupational accidents and its association with socio-demographic factors (age, gender, education), employment and working conditions, work shifts, safety (exposure to unprotected openings and holes, ladders, slopes, a lack of cleanliness, clutter, poor lighting, lack of protection, and tools in poor condition), alcohol consumption, mental health, use of personal protective equipment (PPE) and manual handling of waste were examined using a structured questionnaire. Descriptive statistics, bivariate analysis (chi square test) and adjusted logistic regression models were carried out.Formal workers were younger (57% over 40 years old), all male and better educated (82% completed the first grade), compared to the informal group (7% over 40 years old, 68% males and 30% completed the first grade). The 12-months-prevalence of occupational accidents among formal garbage collectors was 37.5% vs 29.5% among informal garbage collectors (p=0.1). Likewise, after adjustment for potential confounders no statistically significant difference between the two groups was found (Odds 1.8; 95% CI: 0.82 to 3.88).Significant risk factors for 12 months prevalence of accidents were lack of gloves (1.84; CI: 1.01 to 3.05) and poor safety conditions at the workplace (2.44; CI: 1.3 to 4.7).Prevalence of accidents at work among garbage collector is high. Workplace safety measures and use of gloves decrease the risk of accidents, therefore researches and interventions on occupational health related to this activity are necessary.