Introduction: Occupational safety and health frameworks have historically been androcentric, often overlooking the specific vulnerabilities of female workers in high-risk industries. This study examined 10-year trends (2015–2024) in disabling occupational injuries among formally employed women in Ecuador’s agriculture, construction, and manufacturing sectors to evaluate pre-pandemic and post-pandemic risk patterns.Methods A nationwide longitudinal study was conducted using administrative records from the Ecuadorian Social Security Institute (IESS). A total of 4,683 disabling occupational injuries among women were analyzed. Age-standardized incidence rates (ASIRs) per 100,000 person-years were estimated using the direct method. Percentage changes (PCs) and incidence rate ratios (IRRs) were utilized to compare temporal and sector-specific patterns, with statistical significance assessed via Z-tests.Results All three sectors followed a U-shaped trajectory, reflecting a marked post-pandemic rebound after the 2020 nadir. Manufacturing achieved the most significant long-term improvement, with a 59.4% net reduction in ASIR (p < 0.001). Conversely, agriculture maintained the highest burden; by 2024, its ASIR rebounded to 523.4 per 100,000, resulting in a relative risk 3.49 times higher than manufacturing (95% CI: 2.87–4.24; p < 0.001). While construction rates initially decreased, they returned to levels statistically comparable to the 2015 baseline by 2024 (ASIR: 195.8; p = 0.476). Notably, a significant age-related shift was observed in construction, with the injury burden increasing among women aged 45–64 years (p < 0.05).Conclusion The post-pandemic recovery in occupational injuries was heterogeneous, significantly widening safety inequalities across sectors. The persistent risk in agriculture and the shifting age profile in construction underscore an urgent need for gender-responsive prevention and sector-specific interventions tailored to the evolving demographic characteristics of the female workforce.