| Award | Year | Category | Recipient(s) | Result | Ref. |
| American Music Awards | 2019 | New Artist of the Year | — | Nominated | |
| Collaboration of the Year | "Old Town Road (Remix)" (featuring Billy Ray Cyrus) | Nominated |
| Favorite Song — Rap/Hip-Hop | Won |
| Favorite Music Video | Nominated |
| Favorite Song — Pop/Rock | Nominated |
| 2021 | Favorite Music Video | "Montero (Call Me by Your Name)" | Won | |
| Favorite Male Pop Artist | — | Nominated |
| 2022 | Collaboration of the Year | "Industry Baby" (with Jack Harlow) | Nominated | |
| Favorite Song — Rap/Hip-Hop | Nominated |
| Favorite Music Video | Nominated |
| Apple Music Awards | 2019 | Song of the Year | "Old Town Road" | Won | |
| APRA Awards | 2023 | Most Performed International Work | "That's What I Want" | Nominated | |
| BBC Radio 1's Teen Awards | 2019 | Best Single | "Old Town Road" | Nominated | |
| Berlin Music Video Awards | 2020 | Best Concept | "Old Town Road" | Nominated | |
| 2022 | Best Director | "Industry Baby" | Nominated | |
| 2024 | "J Christ" | Nominated | |
| BET Awards | 2020 | Best New Artist | — | Nominated | |
| BET Hip Hop Awards | 2019 | Best New Hip Hop Artist | — | Nominated | |
| Single of the Year | "Old Town Road (Remix)" (featuring Billy Ray Cyrus) | Won |
| Best Collab, Duo or Group | Won |
| 2021 | Best Hip Hop Video | "Montero (Call Me by Your Name)" | Nominated | |
| Impact Track | Nominated |
| Billboard Music Awards | 2020 | Top New Artist | — | Nominated | |
| Billboard Chart Achievement (fan-voted) | — | Nominated |
| Top Male Artist | — | Nominated |
| Top Hot 100 Artist | — | Nominated |
| Top Streaming Songs Artist | — | Nominated |
| Top Song Sales Artist | — | Nominated |
| Top Rap Artist | — | Nominated |
| Top Rap Male Artist | — | Nominated |
| Top Hot 100 Song | "Old Town Road (Remix)" (featuring Billy Ray Cyrus) | Won |
| Top Streaming Song | Won |
| Top Selling Song | Won |
| Top Collaboration (fan-voted) | Nominated |
| Top Rap Song | Won |
| 2022 | Top Male Artist | — | Nominated | |
| Top Streaming Songs Artist | — | Nominated |
| Top Collaboration | "Industry Baby" (with Jack Harlow) | Nominated |
| Top Rap Song | Won |
| Top Billboard Global 200 (Excl. U.S.) Song | "Montero (Call Me by Your Name)" | Nominated |
| BMI Pop Awards | 2022 | Songwriters of Most Performed Song of the Year | Won | |
| "Industry Baby" | Won |
| Bravo Otto | 2019 | Newcomer | — | Nominated | |
| Brit Awards | 2022 | International Artist of the Year | — | Nominated | |
| Best International Song | "Montero (Call Me by Your Name)" | Nominated |
| Cannes Lions International Festival of Creativity | 2022 | Entertainment Lions for Music | "Industry Baby" (with Jack Harlow) | Silver | |
| Lil Nas X “Montero” | Shortlisted |
| Ciclope Festival Awards | 2021 | Visual Effects in a Music Video | "Call Me by Your Name" | Nominated | |
| Country Music Association Awards | 2019 | Musical Event of the Year | "Old Town Road (Remix)" (featuring Billy Ray Cyrus) | Won | |
