The high numbers of fatal and non-fatal accidents in the architecture, engineering and construction (AEC) industry continue to dominate the international Occupational Health and Safety (OHS) agenda. This paper aims to critically review the cost implications of construction accidents to engender control systems. Two illustrative case studies were reviewed and formed the basis for analysis. Case studies research approach was deemed necessary to illustrate the correlation between accidents and their cost implications. The study confirmed that accidents have substantial cost implications for enterprises and society, arising through direct costs (DCs) and indirect costs (IDCs). Higher percentages of DCs incurred by construction enterprises arise from wage and medical expenses. At the same time, IDCs actualize through production disturbance costs (i.e., overtime costs), additional medical, consumables and funeral costs and administrative costs (i.e., incident investigation). The study affirmed that IDCs are substantially more than DCs, i.e., two times greater in most cases. Falling from height was the leading
cause of fatal and nonfatal injuries and, consequently, the highest contributor to both DCs and IDCs and hence, the total cost of accidents (CoA). To obviate the irreparable consequences of CoA on contractors’ profitability and workers’ OHS, construction enterprises should address operational challenges with modern construction methods, such as off-site construction (OSC) supportive of no harm to people