This study describes the use of pesticides mixtures and their potential association with comet assay results in 223 rice field workers in Colombia. Thirty-one pesticides were quantified in blood, serum, and urine (15 organochlorines, 10 organophosphorus, 5 carbamates, and ethylenethiourea), and the comet assay was performed. Twenty-four (77.42%) pesticides were present in the workers. The use of the maximum-likelihood factor analysis identified 8 different mixtures. Afterwards, robust regressions were used to explore associations between the factors identified and the comet assay. Two groups of mixtures— α-benzene hexachloride (α-BHC), hexachlorobenzene (HCB), and β-BHC (β: 1.21, 95% confidence interval [CI]: 0.33–2.10) and pirimiphos-methyl, malathion, bromophos-methyl, and bromophos-ethyl (β: 11.97, 95% CI: 2.34–21.60)—were associated with a higher percentage of DNA damage and comet tail length, respectively. The findings suggest that exposure to pesticides varies greatly among rice field workers.