Sacramento’s job market is fueled by a powerful mix of government institutions, booming healthcare networks, expanding tech hubs, and major construction and infrastructure projects. High-earning professionals in medicine, executive leadership, law, and engineering continue to dominate the region, with many roles exceeding $200,000 annually. As California’s capital grows into a competitive innovation and policy center, specialized expertise, advanced education, and leadership skills remain key pathways to securing top-tier compensation in this thriving economy.

Highest-paid jobs in Sacramento – Top Earning Specialists

1. Anesthesiologist – $368,752

Anesthesiologists are among Sacramento’s highest-earning medical specialists, responsible for administering anesthesia during surgeries and closely monitoring patient vital signs before, during, and after procedures. Their work requires extreme precision and rapid decision-making, especially during complex or emergency operations. With Sacramento’s growing hospital systems and demand for advanced care, these professionals play a critical role in operating rooms, pain management clinics, and trauma centers. Their extensive medical training and critical responsibilities contribute to their exceptional earning power.

2. Surgeon – $350,000+

Surgeons perform life-saving operations across hospitals and specialized surgical centers, handling procedures ranging from trauma repairs to cardiovascular and orthopedic surgeries. Sacramento’s medical hubs and regional trauma centers drive steady demand for skilled surgeons. Their expertise requires years of medical school, residency, and subspecialty training. Surgeons must maintain precision, stamina, and complex clinical judgment while managing high-risk patients. Their specialized knowledge and responsibility for patient outcomes justify some of the highest salaries in the region.

3. Psychiatrist – $310,000+

Psychiatrists diagnose and treat mental health disorders, working in hospitals, private practices, and community health programs. Sacramento’s rising focus on behavioral health—supported by state programs and major medical systems—fuels strong demand for psychiatric expertise. These physicians prescribe medication, oversee treatment plans, and provide therapy for conditions such as anxiety, depression, addiction, and severe psychiatric disorders. With increasing public awareness and mental-health funding, psychiatrists play a crucial role and command top-tier compensation.

4. Radiologist – $290,000+

Radiologists specialize in medical imaging, interpreting X-rays, CT scans, MRIs, and ultrasounds to diagnose health issues ranging from fractures to cancer. Sacramento’s expanding diagnostic centers and teaching hospitals rely on radiologists to guide accurate treatment planning. Their role combines advanced technology proficiency with deep medical knowledge. Because they support nearly every medical specialty and often assist in emergency and oncology cases, radiologists earn some of the highest healthcare salaries in the region.

5. Orthodontist – $270,000+

Orthodontists correct dental alignment issues using braces, aligners, and corrective treatments to improve oral function and aesthetics. In Sacramento’s growing suburban communities, demand remains high for orthodontic services among children and adults. Their extensive dental and orthodontic training allows them to manage complex jaw and bite issues. With many operating private practices and offering premium cosmetic services, orthodontists enjoy strong local earning potential supported by steady patient demand and discretionary dental spending.

6. Chief Executive Officer (CEO) – $300,000+

CEOs oversee strategy, performance, and long-term direction for corporations, nonprofit organizations, and public agencies across Sacramento’s diverse economy. They manage executive teams, guide financial planning, and make critical high-stakes decisions shaping organizational success. Sacramento hosts major government-related enterprises, healthcare systems, utilities, and real-estate firms—creating opportunities for seasoned leaders. With high responsibility, long work hours, and extensive experience required, CEOs command strong compensation reflecting their strategic impact and leadership accountability.

7. General Practitioner – $250,000+

General practitioners serve as primary-care physicians, diagnosing illnesses, coordinating treatments, and providing preventive healthcare. Sacramento faces continued demand for primary-care doctors due to population growth and increased access to insurance. These physicians are essential in family medicine clinics, hospital networks, and community health centers. Their role requires broad medical knowledge, excellent patient communication, and ongoing learning to manage diverse conditions. Strong community need and foundational healthcare importance drive competitive salaries.

8. Corporate Lawyer – $240,000+

Corporate lawyers advise businesses on legal matters including contracts, mergers, compliance, employment law, and regulatory issues. Sacramento’s status as California’s capital—and proximity to technology, healthcare, and public-policy sectors—creates steady demand for corporate legal expertise. These attorneys often represent large institutions, government-linked organizations, and private firms. Their high salary reflects years of legal training, complex case management, and the financial impact of their guidance on major transactions and legal strategies.

9. VP of Operations – $230,000+

Vice Presidents of Operations oversee day-to-day business performance, productivity, and growth strategies. In Sacramento, they are key leaders across healthcare systems, construction firms, logistics networks, and public-sector organizations. Their role involves streamlining operations, improving efficiency, overseeing budgets, and managing large teams. With deep experience in organizational leadership and operational planning, VPs of Operations ensure business continuity and long-term success, earning top compensation for broad-scope managerial responsibility and strategic oversight.

10. Pediatrician – $230,000+

Pediatricians provide medical care for infants, children, and adolescents, performing routine exams, diagnosing illnesses, and advising families on child health. Sacramento’s expanding family-oriented communities and strong pediatric care networks support steady demand. These physicians require specialized training in childhood health and development. Their work blends medical expertise with patience, communication, and long-term family relationships. Strong community reliance on pediatric specialists ensures competitive earnings and consistent need in regional healthcare systems.

11. Emergency Medicine Physician – $220,000+

Emergency medicine physicians treat urgent medical conditions ranging from trauma and cardiac events to infections and injuries. Sacramento’s busy emergency rooms and trauma centers depend on these specialists for rapid diagnosis and life-saving intervention. Their work environment demands fast decision-making, resilience, and the ability to stabilize critical patients under pressure. With high stress and intense workloads, emergency physicians earn substantial salaries reflecting their life-or-death responsibilities and essential role in acute care.

12. Chief Financial Officer (CFO) – $280,000+

CFOs manage financial strategy, budgeting, investments, and risk for corporations, hospitals, and public-sector institutions. Sacramento’s diverse economy—including major healthcare systems, government agencies, and real-estate developers—relies on experienced financial leaders. CFOs oversee financial reporting, capital planning, and compliance, shaping long-term fiscal health. Their compensation reflects deep financial expertise, decision-making authority, and responsibility over organizational stability and growth. Skilled CFOs help organizations navigate economic cycles and major strategic developments.

13. Chief Operating Officer (COO) – $260,000+

COOs guide internal operations, improve performance, and support company goals through process optimization and leadership management. In Sacramento, COOs are essential in healthcare networks, logistics companies, construction firms, and public-sector organizations. They coordinate multiple departments, ensure efficiency, and implement organizational strategy. With a broad view of business execution and staff performance, COOs act as second-in-command to CEOs. Their high compensation reflects multi-disciplinary expertise and direct impact on organizational success.

14. Dentist – $200,000+

Dentists diagnose oral diseases, perform restorative procedures, extract teeth, and provide preventive care. Sacramento’s population growth and emphasis on dental wellness contribute to strong demand for dental services. Many dentists operate private practices, benefiting from patient relationships and recurring care. Their training includes years of education and clinical practice, and they must stay current with dental technologies. Cosmetic dentistry also drives earning potential, making dentistry both essential and financially rewarding locally.

15. Nurse Anesthetist (CRNA) – $185,000+

CRNAs administer anesthesia and monitor patients before, during, and after procedures, working alongside physicians and surgical teams. Sacramento’s busy surgical centers and growing demand for anesthesia services support high salary prospects. CRNAs undergo extensive nursing and anesthesia training and often work independently in certain clinical settings. Their critical responsibilities in pain management and surgical care justify strong compensation, and they remain one of the most highly paid advanced-practice nursing roles.

16. Chief Medical Officer – $260,000+

CMOs oversee medical staff, establish clinical standards, and ensure quality patient care across hospitals and health systems. Sacramento’s expanding healthcare infrastructure relies on CMOs for strategic leadership, regulatory oversight, and clinical policy execution. These leaders collaborate with physicians, administrators, and government partners. Their deep clinical background and executive management skills make them essential to organizational success, and their compensation reflects the importance of maintaining care standards, compliance, and patient outcomes.

17. Hospital Administrator – $225,000+

Hospital administrators manage operations, staffing, budgeting, and patient services across medical facilities. Sacramento’s growing network of hospitals and specialty clinics requires strategic administrative leadership to oversee daily functions and long-term planning. These executives balance financial management with quality-of-care initiatives, working closely with physicians and department managers. Their role demands strong organizational, leadership, and regulatory knowledge, contributing to high salaries aligned with the scale and complexity of healthcare operations.

18. Senior Investment Banker – $250,000+

Senior investment bankers handle mergers, acquisitions, financing strategies, and corporate advisory services. While Sacramento is not a Wall Street hub, it has a strong finance presence tied to government contracts, real estate, utilities, and private equity activity. These bankers manage high-value deals and investment portfolios, requiring analytical expertise, negotiation skills, and deep market knowledge. Their high earnings reflect the financial impact of their decisions and the competitive nature of top-tier finance roles.

19. Tax Attorney – $215,000+

Tax attorneys advise individuals and companies on complex tax regulations, audits, and corporate tax planning. Sacramento’s government environment and significant business sector create demand for tax specialization, particularly for compliance and regulatory guidance. They represent clients before tax agencies, develop tax-efficient strategies, and interpret evolving laws. Their deep legal expertise, experience with high-value transactions, and ability to minimize financial risk help justify strong compensation, especially for senior-level specialists.

20. Engineering Director – $210,000+

Engineering directors oversee engineering teams, lead major infrastructure or product projects, and guide technical strategy. In Sacramento, they are critical in construction, public works, utilities, energy, and tech R&D sectors. Their role blends leadership with advanced engineering expertise, ensuring projects meet safety, cost, and performance standards. Years of experience, technical mastery, and high-stakes project oversight contribute to strong compensation. As Sacramento expands infrastructure and green-technology initiatives, these leaders remain in high demand.

Top 100 Highest-Paid Jobs in Sacramento (Full List)

#	Job Title	Avg Salary (USD/Year)
1	Anesthesiologist	$368,752
2	Surgeon	$350,000+
3	Psychiatrist	$310,000+
4	Radiologist	$290,000+
5	Orthodontist	$270,000+
6	CEO	$300,000+
7	General Practitioner	$250,000+
8	Corporate Lawyer	$240,000+
9	VP of Operations	$230,000+
10	Pediatrician	$230,000+
11	Emergency Medicine Physician	$220,000+
12	CFO	$280,000+
13	COO	$260,000+
14	Dentist	$200,000+
15	Nurse Anesthetist (CRNA)	$185,000+
16	Chief Medical Officer	$260,000+
17	Hospital Administrator	$225,000+
18	Senior Investment Banker	$250,000+
19	Tax Attorney	$215,000+
20	Engineering Director	$210,000+
21	Senior Pharmacy Director	$205,000+
22	Data Engineering Director	$200,000+
23	Software Engineering Director	$200,000+
24	Senior Civil Engineer Manager	$195,000+
25	Senior Project Manager (Construction)	$190,000+
26	Senior Actuary	$190,000+
27	Marketing Director	$190,000+
28	Senior Solutions Architect	$185,000+
29	HR Director	$200,000+
30	Real Estate Development Director	$200,000+
31	Senior Financial Controller	$180,000+
32	Senior IT Director	$180,000+
33	Pharmacy Manager	$175,000+
34	Sales Director	$180,000+
35	Judge	$180,000+
36	Public School Superintendent	$175,000+
37	Senior Mechanical Engineer	$170,000+
38	Senior Electrical Engineer	$170,000+
39	Senior Civil Engineer	$165,000+
40	Senior Nurse Practitioner	$160,000+
41	Business Development Manager	$160,000+
42	Risk Manager	$200,000+
43	Senior Auditor	$170,000+
44	Senior Wealth Manager	$160,000+
45	Physician Assistant	$155,000+
46	IT Security Manager	$150,000+
47	Senior Policy Advisor	$150,000+
48	Airplane Pilot	$150,000+
49	Senior Environmental Engineer	$145,000+
50	Radiology Technologist Lead	$145,000+
51	Senior Accountant	$150,000+
52	Cloud Architect	$135,000+
53	Data Scientist	$110,000+
54	Machine Learning Engineer	$125,000+
55	DevOps Engineer	$120,000+
56	Senior Social Work Administrator	$135,000+
57	Cybersecurity Analyst	$115,000+
58	Senior Database Administrator	$135,000+
59	Systems Architect	$115,000+
60	IT Project Manager	$100,000+
61	Software Engineer	$120,000+
62	Full Stack Developer	$105,000+
63	Legal Compliance Manager	$145,000+
64	Real Estate Broker (Top)	$150,000+
65	City Planning Director	$155,000+
66	Construction Superintendent	$120,000+
67	Quality Assurance Engineering Manager	$135,000+
68	Supply Chain Director	$150,000+
69	Air Traffic Controller	$140,000+
70	Senior Biotech Researcher	$145,000+
71	Clinical Laboratory Director	$155,000+
72	Mental Health Program Director	$130,000+
73	Fire Chief	$140,000+
74	Police Chief	$140,000+
75	Federal Law Enforcement Agent	$125,000+
76	Nuclear Medicine Technologist	$135,000+
77	Physical Therapist (Lead)	$115,000+
78	Occupational Therapist (Lead)	$115,000+
79	Public Relations Director	$145,000+
80	UX Designer (Senior)	$105,000+
81	Senior Paralegal Manager	$110,000+
82	Rail Operations Manager	$125,000+
83	Logistics Director	$120,000+
84	Strategic Partnerships Manager	$130,000+
85	Industrial Engineer	$110,000+
86	Biomedical Engineer	$115,000+
87	Financial Analyst (Senior)	$130,000+
88	Treasury Analyst (Senior)	$120,000+
89	Healthcare Administrator	$125,000+
90	Energy Analyst	$118,000+
91	Environmental Scientist (Senior)	$110,000+
92	Renewable Energy Project Manager	$120,000+
93	Hospital HR Manager	$120,000+
94	Construction Estimator (Senior)	$115,000+
95	Government Affairs Manager	$140,000+
96	Policy Compliance Specialist	$110,000+
97	Clinical Research Coordinator (Senior)	$105,000+
98	Insurance Underwriting Manager	$120,000+
99	Technical Writer (Senior)	$100,000+
100	HR Manager	$105,000+

Closing

Sacramento’s income landscape clearly favors highly trained medical experts, senior executives, advanced engineers, and financial specialists—but strong opportunities also exist across IT, construction, public safety, and logistics. Whether you’re planning a career move, exploring high-growth fields, or evaluating educational paths, these roles highlight where the greatest earning potential lies. With the region continuing to expand in technology, healthcare, and clean-energy infrastructure, Sacramento is poised to offer even more high-paying opportunities in the years ahead.