Objective: To analyze the occurrence of unintentional injuries among college students and their association with sexual orientation and gender identity, so as to provide a targeted scientific basis for injury prevention measures and intervention strategies. Methods: From October 24 to November 18, 2023, a sample of 1 629 college students from two general universities in Beijing was selected using convenience sampling method. A questionnaire survey was conducted to collect information on the gender identity, sexual orientation and occurrence of unintentional injuries among college students in the past year. The Symptom Checklist-90 (SCL-90), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ), and Delaware Bullying Victimization Scale-Student (DBVS-S) were used to assess mental health, sleep quality, childhood trauma, and dysfunctional impulsivity status. Analyses of sexual orientation and gender identity were conducted. The t-test and Chi square test were used for intergroup comparison,and multivariate Logistic regression analysis was used to examine risk factors for unintentional injuries among college students of different gender identities. Results: The incidence rate of unintentional injuries among college students was 16.94%, with boys (17.08%) being higher than girls (16.90%). Compared with those who did not experience unintentional injuries (5.28± 3.60 , 118.68±41.38), college students who experienced unintentional injuries had poorer sleep quality and mental health status ( 6.38 ±3.93, 135.59±50.96)( t =-3.92, -4.26); the differences in the incidence of unintentional injury among college students with non suicidal self injury, interpersonal violence, childhood trauma, and different sexual orientations and gender identities were all statistically significant ( χ 2=28.75, 75.18, 9.83, 16.20, 4.13) (all P <0.05). Multivariate Logistic regression analysis showed that after adjusting for age, gender and body mass index, non heterosexual orientation increased the risk of unintentional injuries ( OR=1.61, 95%CI =1.09-2.38), whereas existing non suicidal self injury behaviors ( OR=2.10, 95%CI =1.02-4.37) and poorer mental health status ( OR=1.54, 95%CI =1.05-2.27) increased the risk of unintentional injuries among non heterosexual college students (all P <0.05). Conclusions The incidence rate of unintentional injuries among college students is relatively high, with non heterosexual groups having increased risk of unintentional injuries. Mental health status and non suicidal self injury behaviors are important factors related to unintentional injuries among non heterosexual college students.