| Award | Year | Category | Work | Result | Ref. |
| Festival International du Film d'Amiens | 2004 | Prix des enfants de la Licorne | Le télégramme | Won | |
| Fajr International Film Festival | 2005 | International Competition – Best Short Narrative Film | Won | |
| Corti Da Sogni Antonio Ricci International Short Film Festival | 2015 | European Sogni Award | Reality+ | Won | |
| Tribeca Festival | 2016 | Jury Award for Best Narrative Short | Nominated | |
| Sitges Film Festival | 2017 | Best Director | Revenge | Won | |
| Citizen Kane Award for Best New Director | Won |
| Monster Fest | Best International Feature | Won | |
| Bucheon International Fantastic Film Festival | 2018 | Best of Bucheon Award | Won | |
| Calgary Underground Film Festival | Jury Award for Best Narrative Feature | Won | |
| Cleveland International Film Festival | New Direction Competition | Nominated | |
| ReelWomenDirect Award for Excellence in Directing by a Woman | Nominated |
| Fangoria Chainsaw Awards | 2019 | Best Director | Nominated | |
| Best Limited Feature | Nominated |
| Cannes Film Festival | 2024 | Palme d'Or | The Substance | Nominated | |
| Best Screenplay | Won | |
| Toronto International Film Festival | 2024 | People's Choice Award: Midnight Madness | Won | |
| European Film Awards | 2024 | European Film | Nominated | |
| European Screenwriter | Nominated |
| San Diego Film Critics Society | 2024 | Best Director | Nominated | |
| Best Original Screenplay | Nominated |
| Seattle Film Critics Society | 2024 | Best Picture | Nominated | |
| Best Director | Nominated |
| Best Screenplay | Nominated |
| Best Editing | Nominated |
| Chicago Film Critics Association | 2024 | Best Director | Nominated | |
| Best Original Screenplay | Nominated |
| Golden Globe Awards | 2025 | Best Director – Motion Picture | Nominated | |
| Best Screenplay – Motion Picture | Nominated |
| Best Motion Picture – Musical or Comedy | Nominated |
| Critics' Choice Movie Awards | 2025 | Best Director | Nominated | |
| Best Original Screenplay | Won |
| London Film Critics' Circle | 2025 | Director of the Year | Nominated | |
| Screenwriter of the Year | Nominated |
| Satellite Awards | 2025 | Best Original Screenplay | Nominated | |
| Independent Spirit Awards | 2025 | Best Feature | Nominated | |
| Dorian Awards | 2025 | Film of the Year | Won | |
| Director of the Year | Won |
| Genre Film of the Year | Won |
| Campiest Flick | Won |
| Screenplay of the Year | Nominated |
| Wilde Artist Award | Nominated |
| Santa Barbara International Film Festival | 2025 | Outstanding Director of the Year | Honored | |
| César Awards | 2025 | Best Foreign Film | Nominated | |
| British Academy Film Awards | 2025 | Best Direction | Nominated | |
| Best Original Screenplay | Nominated |
| Academy Awards | 2025 | Best Picture | Nominated | |
| Best Director | Nominated |
| Best Original Screenplay | Nominated |