Objectives. To analyze changes in occupational health inequity between 2011 and 2018 among workers in Central America. Methods. Data were collected by face-to-face interviews at the workers' homes for the 2 Central America Working Conditions Surveys (n = 12 024 in 2011 and n = 9030 in 2018). We estimated health inequity gaps by means of absolute and relative population attributable risks and the weighted Keppel index. We stratified all analyses by gender. Results. Between 2011 and 2018, the proportion of workers reporting poor self-perceived health decreased both in women (from 32% to 29%) and men (from 33% to 30%). However, the health inequity gaps remained wide in the 4 stratifiers. Measured by the Keppel index, health inequity gaps between countries increased from 22% to 39% in women and from 20% to 29% in men. Conclusions. While health improved between 2011 and 2018, health inequity gaps remained wide. Wider health inequity gaps were observed between countries than by gender, age, occupation, or education. Public Health Implications. This first benchmark of occupational health inequities in Central America could be useful when developing and evaluating the impact of public policies on work.