Occupational differences remain a defining source of health inequality, particularly in developing economies where work conditions and access to care vary sharply across social groups. This paper on Occupational Stratification and Health Outcomes: A Comparative Analysis of Blue-Collar and White-Collar Workers in Nigeria, examined how occupational position shapes physical health outcomes, psychosocial and lifestyle-related conditions, and access to healthcare services. The paper was anchored on Fundamental Cause Theory, which explains how unequal access to resources influences exposure to health risks and the ability to manage illness. A comparative analytical review method was adopted, drawing on recent studies between 2020 and 2026, with systematic selection and thematic analysis of peer-reviewed literature relevant to occupational health and labour structure. The findings revealed that blue-collar workers experience a higher burden of physical injuries, musculoskeletal disorders, and exposure-related illnesses due to hazardous working conditions, while white-collar workers show increasing prevalence of chronic conditions linked to sedentary lifestyles and workplace stress. The analysis further indicated that psychosocial stress differs in form, with economic insecurity shaping outcomes among manual workers and organizational pressure affecting non-manual workers. In addition, access to healthcare and occupational health provisions were found to remains uneven, favouring white-collar workers within formal employment structures. The paper concluded that occupational stratification continued to structure health inequalities through differential exposure and resource distribution. It therefore recommended among others stronger enforcement of workplace safety regulations, expansion of inclusive health insurance schemes, and context-specific workplace health interventions.