Unintentional drowning, intentional drowning, and water immersion deaths unrelated to drowning are the three most common presentations in bodies found in water. Drowning is common and a mainly preventable cause of death. Preventative measures may depend on local and regional characteristics of these deaths, and understanding regional underlying characteristics may help in death prevention. This six-year retrospective study in Gold Coast (Queensland, Australia) compared the characteristics of drowning and water immersion deaths. While there are overarching similarities, some regional characteristics differed from other regional, national, and international data. Differing from other studies, we have found a high proportion of local Australian residents predominantly drowning at sea. This study gives evidence that regional specific strategies may be needed to further prevent drowning and immersion deaths.