Introduction:Risk of occupational accidents in construction industry and sites is very high and dangerous. The establishment of an effective and efficient risk management system is an important step in prevention of construction accidents. The purpose of this study was to analyze the HSE risk management systems in large construction sites and their association with the occupational accidents. Methods: This study was an analytical cross-sectional review that analysis the risk management system and its relation to the accidents of 88-92 years that has been occurred in the construction large sites. Study data includes information about the all HSE risk management systems and human accidents that occurred within 5 years in the various construction sites. Data collection was performed according to the accident report form in construction sites. Data analysis was performed using SPSS software version 16. The level of significance in this study was considered as p=0.05. Results: The mean accident severity rate (ASR) was 1.51×103±1.05×104. The results showed that,risk management system has been established in 18.4% of the studied sites, and the share of the risk management system components and indicators including hazard identification, periodic risk assessment and the implementation of control procedures which was estimated 16.4%, 16.6% and 10.2% respectively.In addition, all indicators of risk management were significantly associated with ASR (p<0.05). Conclusion:ASR Regression analysis based on the risk management Indicators, showed that demographic and job parameters such as work experience and career type, as well as, risk management indicators such as the risk management system establishment,HAZID, periodic risk assessment, HSE training and Housekeeping have been significant associated with accidents consequence severity in the construction industry.