Objective: To identify environmental factors present in areas with high density of road traffic accidents (RTA) in Leon, Nicaragua. Methods: The analysis included all accidents recorded by the Police Department in León City, from January to June 2017. All crashes were georeferenced, and data were collected from the environment elements within a perimeter of 20 meters from the site in which accidents occurred with a pre-tested data collection instrument. We specified a Poisson regression model to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) to determine environmental factors associated with the event incidence. For the identification areas with high, medium, and low occurrences of crashes, kernel density around points in which RTA occurred were estimated. Results: Out of 667 recorded crashes, 90% involved men aged 15–40, and motorcycle accidents represented 60% of injuries or deaths. Environmental factors that were positively associated with RTA included good road conditions (adjusted IRR = 1.36, 95%CI 1.13 – 1.63) and the existence of bicycle lanes (adjusted IRR = 1.64, 95%CI 1.29 – 2.10). Environmental characteristics associated with higher speeds and heavier accidents can increase their incidence. Conclusion: We found that high-foot-traffic commercial or touristic centers are three areas with high density of crashes. Local authorities can use these findings to promote road safety measures in high-incidence areas in León City.