Construction industry is a risky industry awing to severe accident occurrence. Although construction managers focus mainly on productivity, however, construction projects can never achieve their objectives unless professionals become aware of the safety-related issues. Previous research suggested that early introduction of occupational safety & health management systems (OHSMS) within the project implementation, is an important asset in decision-making as it directs towards the abatement of occupational hazards in the workplace.  In accordance with these researches, this paper aims to study the impact of OHSMS on reducing construction site accidents. The paper explored through a literature review the major causes of construction accidents and explains OSHMS, and their effects. Afterwards, the implementation of OCS practices at construction sites in three case study projects were analyzed; two projects Malaysia and a case study in Egypt. The data for the local case study was collected through a semi-structured interview that targeted the site safety manager. A comparison was finally held between the Malaysian and the Egyptian case to evaluate the safety practices. The study concluded that implementing OHSMS would lead to a significant reduction in site-accidents. Moreover, health and safety should be included from preparation of contract documents. It is recommended that top management of construction companies to be more committed to safety and health procedures, in addition, there is need to provide funding for the regulatory body that oversees health and safety in construction industry as well.