Occupational accidents happen for a reason. In this study, statistics compiled by the Ministry of Labor on major occupational accidents in the construction industry during 2000-2014 in Taiwan were analyzed; a direct observation of a construction site was made; and interviews with contractors, supervisors, and workers were conducted to identify the causes of accidents and safety management failures. The results suggested that improving the safety behavior of frontline workers was critical to reducing occupational accidents. In addition, the findings of the field research showed that low- price bidding, subcontracting, pressure to meet deadlines, and labor shortages were commonly involved in the implementation of contracted construction projects. Consequently, numerous construction firms were unable to perform safety and hygiene management sufficiently, despite perceiving such management as crucial. To effectively reduce occupational accidents in the construction industry, the government can conduct regular inspection visits to construction sites and formulate penalties. Additionally, construction firms can invest further in safety and hygiene management to improve worker safety at higher heights, provide daily training sessions and notifications about work-related hazards before work begins, perform frequent walk-around checks, and issue safety instructions whenever necessary.