Background: Work at heights is a high-risk occupational activity, with falls being a leading cause of fatal accidents in construction and industrial maintenance. Conventional safety training often does not fully prepare workers for real-world hazards. Immersive virtual reality (IVR) has emerged as a promising training tool, providing controlled and realistic simulations of hazardous scenarios. This hypothesis-generating pilot study evaluates the feasibility and effectiveness of IVR in enhancing practical skills, safety perception, and physiological responses during work-at-height training. Methods: This controlled trial will recruit first-time trainees from the National Learning Service (SENA) of Colombia. Participants will be assigned to an intervention group, receiving IVR training before field-based practical sessions, or a control group, receiving standard theoretical instruction. Outcomes include practical skill acquisition, ergonomic risk, cognitive performance, and physiological responses, including heart rate variability measured with validated devices. Assessments will be performed using standardized tools, and data will be analyzed with repeated-measures ANOVA and regression models to compare groups. Conclusions: By integrating practical, cognitive, ergonomic, and physiological measures, this study will provide evidence on whether IVR improves the effectiveness of work-at-height training beyond conventional methods. Findings may inform future strategies to enhance occupational safety training in high-risk work environments.