BACKGROUND: The geographical circumstances, such as mountains and ocean, and specific aviation operations, especially sightseeing, make the state of Hawaii stand out in aviation. These conditions support a regional approach to aviation accident analysis.METHODS:Accident reports of aviation accidents collected from the online National Transportation Safety Board database were used to study a 10-yr time period between 2008 and 2017.RESULTS: There was a significantly higher proportion of fatal accidents during night, dawn, and dusk (6 out of 13) than during daytime (13 out of 74). In addition, a significantly higher proportion of accidents occurred in diminished light conditions among fixed wing airplanes (11 out of 48) as opposed to other aircraft (2 out of 39), and among twin-engine aircraft (6 out of 12) as opposed to single-engine aircraft (7 out of 74). Out of seven weight-shift control aviation accidents, four were reported to be fatal; the latter all took place during instruction.DISCUSSION: Light conditions are the main environmental concern in Hawaiian aviation that particularly affect twin-engine fixed wing aircraft and warrant specific attention in advanced training exercises. Helicopter operations have not exhibited a diminished safety record since the 1990s, showing a lasting effect of a previous safety intervention. A relatively high number of fatal weight-shift control aircraft accidents requires further research in other parts of the United States.de Voogt AJ, Brause J. A regional approach to aviation accident analysis in Hawaii. Aerosp Med Hum Perform. 2023; 94(3):131-134.