Adverse incidents are a global issue and constitute the leading cause of death, although many are preventable. Patient safety is a significant challenge faced by healthcare professionals in hospitals. It is an essential element of high-quality care, which can negatively cause a deficiency in reporting clinical incidents. Healthcare professionals report only 1-3% of clinical incidents. Aim: This study investigated healthcare providers' awareness of occurrence variance reports and their magnitude at accredited versus non-accredited hospitals. Material and methods: A cross-sectional descriptive design was used. Three hundred seventy-three healthcare providers participated in the study (232 staff nurses, 96 physicians, and 45 pharmacists). They were recruited using a convenience sample from two universal health insurance hospitals in Port-Said, Egypt. Data collection tools: The Occurrence Variance Report (OVR) awareness questionnaire and OVR (paper-based forms) were used to report incidents in the two hospitals, with 522 from the accredited hospital and 258 from the non-accredited hospital. Results: It pointed out that healthcare providers in the accredited hospital had the highest awareness mean score of occurrence variance report (224.53) compared to non-accredited hospitals (153.47). Also, the accredited hospital had a higher frequency of all occurrence variance report classifications than a non-accredited hospital, with near misses being the most common (170) than other types, followed by sentinel events (148), major events (109), and occurrences (95). Conclusion: The total score of awareness dimensions and the total score of OVR frequency reported by all healthcare providers in the two hospitals had a moderately significant relationship (r = 0.283 at p = 0.045*). Recommendations: Implement policies that organize safe cultural behaviors, such as writing occurrence variance reports and holding frequent training sessions on the importance of incident reporting. Furthermore, more research is suggested to identify factors and barriers influencing the OVR system.