Unconventional and conventional oil and gas (O&G) operations raise public health concerns, such as the potential impacts from trucking activity in communities that host these operations. In this work, we used two approaches to evaluate accidents in relation to O&G activities in the State of Colorado. First, we calculated the rate of truck accidents by computing the ratio of accident count and county population. When comparing counties with increased O&G operations to counties with less activity, we found that counties with more activity have greater rates of truck traffic accidents per capita (Rate Ratio = 1.07, p < 0.05, 95% CI: 1.01–1.13). Second, we laid a grid over the eleven counties of interest and counted, for each cell, the number of truck accidents, the number of multivehicle accidents with injuries, the number of homes, and the number of O&G wells. We then applied hurdle count models, using the accident counts as the outcomes and the number of homes and number of wells as independent variables. We found that both independent variables are significant predictors of truck accidents and multivehicle truck accidents. These accidents are of concern since they can have an impact on the people who live near O&G operations.