The generation of tailings in the world today is immense, since only ounces or pounds of metals are extracted for each ton of ore processed. In 2022, it was estimated that more than 14 billion metric tons of mining tailings were produced per year in the world. Currently, many environmental problems associated with tailings management in both Chile and Peru are related to the potential contamination of soil, water, and air. In this article, the environmental impacts caused by tailings storage facility accidents where spills have occurred are analyzed, describing and characterizing: (i) the magnitude of the impacted area, (ii) identification of the sources, i.e., exposure routes, receptors, and (iii) an interpretive analysis of the physicochemical quality of the spilled material, the soil, the water, and the air with respect to local and international regulations. The case studies analyzed in this article correspond to tailings spills derived from the extraction of precious metals (Au, Ag) and heavy metals (Cu, Pb, and Zn) present in the minerals that dominate Chilean and Peruvian mining. Finally, environmental management measures are proposed aimed at mitigating the environmental impacts caused by the spill and remediation alternatives for the sites impacted.