Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. This study presents a preliminary geospatial analysis of OHCA in some provinces of Lombardy (Italy), over the 2015–2023 period. Geospatial analysis can identify areas at high risk of OHCA, highlighting clusters, referred to as “hot-spots” where the occurrence of OHCA is significantly higher than in neighbouring areas or those areas with an increasing number of OHCA during time. This study represents the first spatial distribution of out-of-hospital cardiac arrest (OHCA) in Italy and particularly in the Lombardy region. Our geospatial analysis highlighted a heterogenous distribution of OHCA through the region. A multiscale approach, using global and local analysis from regional to provincial level, highlighted substantial local differences. These differences may be associated with physical features, such as mountains vs. lowland, socioeconomic aspects, such as urban patterns, population density, and rurality, as well as with environmental factors, such as air pollution. We are aware of the limitations of our study and of the importance to refine the territorial grid depending on the purpose. Our results, albeit preliminary, could provide insights for future research in OHCA spatial analysis.