<h3>Abstract</h3> <h3>Objective</h3> This paper describes the epidemiology of home- and work-related injuries, their mechanisms, inequalities and costs associated with these injuries. <h3>Methods</h3> A household survey was undertaken in three palikas (administrative areas) of Makwanpur district between April-June, 2019. Data were collected electronically on non-fatal injuries that occurred in the previous three months and fatal injuries that occurred in the previous five years. <h3>Findings</h3> 17,593 individuals were surveyed from 3,327 households. The injury rate was 8.0/1000 population for home injuries and 6.4/1000 for work-related injuries; 61.0% of home injuries were among females and 69.9% of work-related injuries among males. Forty-eight percent of all home injuries were due to falls (28 males (50.9%) and 40 females (46.5%)); burn/scalds were higher among females 15 (10.5%). Cuts and piercings accounted for 40% of all work-related injuries and 36.3% were falls. Injury incidence varied by ethnic group: home injuries were highest in Brahmin (12/1000) and work-related injuries highest in Rai groups (21.0 per 1000). The total mean cost of work-related injury was US$143.3 (SD 276.7), higher than for home injuries (US$130.4, SD 347.6). The number of home (n = 74, 64.9%) and work-related (n = 67, 77.9%) injuries were higher in families below the poverty line (<US$1.9) than families in the next income bracket (US$1.9–3.2)(home: n = 22, 19.3%; work: n = 11, 12.8%). <h3>Conclusions</h3> Home and occupational fall injuries are common. The inequalities in injury identified in our study by rurality, age, sex, income level and ethnic group can help target injury prevention interventions for vulnerable groups. <h3>What is already known on the subject</h3> Limited epidemiological data are available in Nepal about the location of injury, activity taking place when injury occurred and the costs of injury There is limited information about the distribution of injuries by ethnicity and income groups. <h3>What this study adds</h3> People from rural areas experience more injuries than people living in urban or city areas Manual workers sustain more work-related injuries than those in other occupations Certain ethnic groups have higher rates of injuries than other ethnic groups People with lower income experience more injuries than people with higher incomes Injury costs are high in relation to average per capita income.