Background: A patient safety culture is something that absolutely must be applied and is the prominent foundation for patient safety, therefore, it could reduce the patient safety incidents at the hospital. The study aims to analyse the effect of patient safety culture toward patient safety incidents at the highest reference hospital in East Kalimantan.\nMethods: Analytical study with the cross-sectional design is applied. There were 119 nurses in 17 rooms as sample. The sample selection was conducted by proportional random sampling. The patient safety culture with 12 dimensions was an independent variable while the dependent variable was a safety incident. Data collection using a questionnaire refers to the AHRQ at the Hospital Survey on Patient Safety Culture in 2017. The patient safety incident questionnaire was prepared based on the incident data that often occurs in the Hospital. Data were analyzed by multiple linear regressions.\nResults: The average nurse\'s perception of the patient safety culture was 2.97 (SD ± 0.22). The lowest mean perception on the dimension of non-punitive response to errors was 2.65 (SD ± 0.60), while the mean of the highest perceptions in the dimensions of collaboration in units was 3.43 (SD ± 0.43). The most common incident was phlebitis (8.4%). There was an influence of management support (p = 0.038, R = 5,633), nurses\' perceptions (p = 0.015, R = 5,609) and cooperation between units (p = 0.006, R = 6,646) toward the incidents of patient safety.\nConclusion: Management support, nurse perceptions, and collaboration between units affect Patient Safety Incidents. These three dimensions of patient safety culture need to be improved, consequently, the incidence of patient safety at the hospital could decrease.