The aim of this study was to analyze the frequency of work-related sick leave in sugarcane workers. A total of 1,230 medical excuses for 400 sugarcane workers were analyzed according to the International Classification of Diseases, 10th Revision (ICD-10). The following items were analyzed: diagnosis, sex, and length and season of sick leave. In all the seasons, musculoskeletal diseases showed the highest sick leave rate, following by respiratory diseases (p < 0.05). Sick leave due to musculoskeletal diseases was more frequent at the end of the sugarcane harvest than during the intercrop season (p < 0.05). Seventy-five percent of medical excuses were for one day. The longest sick leaves were for diseases of the genitourinary tract (p < 0.001). It is thus essential to have a multidisciplinary health team focused on the development of ergonomic activities, personal protective equipment, and health orientation specifically targeting this group's needs.