Background <p>In coastal Bangladesh, due to the different roles of male and female fisherfolk, occupational hazards and risks can also be distinctive. However, there is limited comparative evidence on the role of gender in their occupational hazards and risks.</p> Objective <p>This study aimed to compare the occupational health hazards and risks among male and female fisherfolk in Chattogram and Cox’s Bazar, Bangladesh.</p> Methods <p>An explanatory sequential mixed-methods design was used. A cross-sectional survey was first conducted among 407 fisherfolk (200 males and 207 females), followed by nine focus group discussions.</p> Results <p>Male fisherfolk were predominantly engaged in direct fishing, whereas female fisherfolk were predominantly involved in dry fish processing. While most of the hazards were found consistently high among both male and female fisherfolk, females were found to have higher chemical exposure and males had higher exposure to heavy weightlifting. A high prevalence of occupational risks, including skin issues, musculoskeletal disorders, and diarrhoea, was observed in both groups. Conditions like fish stings/bites, sea sickness, and earache were found significantly higher among male fisherfolk. Female fisherfolk had specific concerns on access to toilets, menstrual hygiene kits, breastfeeding space and maternity leave. Drowning and falling overboard, cyclones and storms, and attacks from pirates were unique hazards for men with higher susceptibility to fatality. PPE use was low among both groups.</p> Conclusions <p>This study revealed a high burden of occupational hazards and risks among both male and female fisherfolk in Bangladesh from a gender lens warranting a gender-sensitive occupational safety and health strategy and action plan.</p>