OBJECTIVES: The Norwegian government declared Vision Zero for serious injuries and fatalities for everyone working at sea in 2022. Occupational accident rates in the Norwegian fishing fleet are higher than those for other maritime industries, and measures must be based on a thorough knowledge of causes. This article aims to provide updated knowledge on causes and risk factors for occupational accidents in the Norwegian fishing fleet. METHODS: Three sources of data were used: 1) A database of fatal accidents updated by the research institute SINTEF Ocean and a registry of occupational injuries kept by the Norwegian Maritime Authority, 2) 40 accident investigation reports published by the Norwegian Safety Investigation Authority, and 3) interviews with 12 active fishers and representatives for key stakeholders involved in fishers' safety. RESULTS: Analyses of occupational accidents indicated more than half of fatalities in the period 2000-2022 were due to vessel disasters and fisher overboard events. Most of those involved worked on vessels that were 6-10.99 m in length. Accident investigation reports published in the period 2013-2023 indicate many overboard accidents happened to fishers working alone and were caused by fishers being dragged overboard with equipment, fishers falling overboard, or ropes under tension suddenly snapping. The interviews revealed the fishers and key stakeholders were concerned about accidents. The underlying causes and risk factors they described were technological (vessel, fishing gear, and equipment), organizational (planning and decision-making, competence and training, working hours, and rest), and regulatory (control and inspections, requirements for safety management, and fisheries management and safety). Furthermore, the interviews indicated fisheries management may have a negative influence on safety and working conditions and need be considered to improve fishing safety. CONCLUSION: Coastal fishers are overrepresented in fatal accidents, while most occupational accidents are reported from sea-going trawlers. Measures should target technological, organizational, and regulatory factors, as well as framework conditions.