A comprehensive understanding of the spatio-temporal characteristics and causal factors associated with major and above coal mine accidents is of significant practical importance in the prevention of such incidents. This paper employs a concentration index and spatial analysis method to examine major and above coal mine accidents in China between 2013 and 2023. The findings indicate that: (1) The number of accidents decreased significantly from 2013 to 2019, and the number of accidents stabilized from 2020 onwards. However, the number of fatalities and direct economic losses increased year by year. There has been a notable improvement in the incidence of gas accidents, while the number of roof accidents has increased. In contrast, water accidents have remained relatively stable, although they have resulted in significant economic losses and have had a considerable impact on local state-owned coal mines. (2) The month of the accident is divided into four phases, each characterized by a distinct level of discretization. The period from October to December was found to have the highest concentration of accidents. The distribution of accidents exhibited a spatial correlation, forming three clusters of high values in a northeast-central-southwest direction. The center of gravity path demonstrated a pattern of alternating northeast-southwest movements. (3) The primary cause of accidents in recent years has been the illegal organization of production. While the issue of illegal operations has been addressed, the problem of inadequate support persists, and the underlying causes of different types of accidents vary. The indirect reasons from 2013 to 2017 were mainly due to inadequate enterprise management capabilities and technical management, whereas in the period between 2018 and 2023, they were predominantly slack corporate management and inadequate employee professionalism. (4) Late reporting and concealment are prevalent in coal-producing provinces, and the involvement of public officials is on the rise. Late reporting and concealment are more likely to occur when the primary cause of accidents originates from the management of enterprises.