A quarter of all drownings in Australia happened in Queensland in the 2016/17 financial year, with the state recording a 9 per cent increase compared to the same period 12 months earlier.
Seventy-three people drowned, including 13 children under the age of four, the Royal Life Saving National Drowning Report showed.
Across the country, 291 people drowned in the report period. New South Wales had the most deaths at 93, and the Australian Capital Territory the lowest number at four.
Rivers were the leading location for fatal drownings with 68 deaths, followed by beaches (50 deaths), the ocean or harbour locations (46 deaths) and swimming pools with 44 deaths.
Royal Life Saving Society Queensland executive director Michael Darben said the report showed the dangers of the nation's waterways were being underestimated.
The figures come despite repeated warnings for parents to keep watch of their children around water.
"Australians love the water," Mr Darben said.
"It's an important part of our culture.
"The sad fact that 291 people drowned last year is a sobering reminder to always actively supervise children around water.
"For people young and old to learn to swim and survive, to increase lifejacket use, reduce alcohol consumption around water and to always Respect the River."
This year's report is the first to consider the impact of both drownings and near-drownings.
It is estimated there were an additional 685 incidents in which people required hospitalisation.
Mr Darben said many of those people would require long-term medical assistance.
