Objective: The purpose of this study is to systematically analyze accident cases involving agricultural tools and equipment and to propose ergonomic improvements to enhance their safety. Background: Although the adoption rate of agricultural tools and equipment is high, their safety remains a significant concern, leading to a high frequency of accidents and substantial compensation costs. Method: This study utilized the 'Agricultural Safety 365' database operated by the Rural Development Administration in the Republic of Korea. The search period for accident cases was set from 'before 2000 to 2019,' and the accident types and locations were set to 'all'. To systematically analyze safety accident cases related to small and medium-sized agricultural tools and equipment, the search scope was set to 'all agricultural tools' and 'transportation-related equipment.' Based on the detailed information provided by the database, the accident scenarios were reconstructed by reviewing key elements such as the accident overview, details, and extent of injuries. The accident scenarios were analyzed from multiple perspectives using the 4M approach (man, machine, media and management), identifying the causes of accidents, original cause material, and assailing materials. Considering various types of tools and equipment, the causes of accidents were categorized, and the frequency of each category was analyzed. Results: The results of this study analyzed the primary agricultural tools and equipment involved in the 126 accident cases as ladder, brush cutter, sickle, carts, power sprayer, and saw. Among these, ladder (28%), brush cutter (25%), sickle (19%), and power sprayer (16%) accounted for approximately 83% of all accident cases. The cause of ladder-related accidents was primarily identified as occurring due to irregular ground (sloped, wet, soft, etc.) conditions in agricultural work environments. The causes of brush cutter-related accidents were primarily analyzed as unsafe behaviors and failure to follow safety work procedures due to human error, along with the lack of personal protective equipment. To ensure the safety of agricultural tools and equipment for the ultra-aged population, it is effective to prioritize improving the physical risk factors. Frequent use of machinery in agricultural work can accelerate aging and deterioration, leading to a lack of management such as regular inspections, maintenance, and repairs. Manufacturers should provide appropriate maintenance schedules and self-repair manuals, while regional agricultural organizations should engage in regular sharing of accident case studies to enable continuous monitoring. Conclusion: To ensure the safety of agricultural work, it is essential to prioritize improvements to the physical risk associated with both the tools, equipment, and the work environment. Agricultural workers need to adopt proactive safety behaviors, such as consistently wearing personal protective equipment and engaging in regular maintenance. Application: Based on the results of this study, it will be possible to ensure the fundamental safety of agricultural tools and equipment, contributing to the creation of a safer agricultural work environment.