The paper examines the key factors that influence risk and safety performance of construction sites, the effects of accidents on construction site and the measures that will improve risk and safety performance on construction sites in the Tamale Metropolis in the Northern Region of Ghana. Three research questions were formulated. The study adopted descriptive research that is mixed methodology approach. The research instruments employed were self- administered questionnaires, interviews and observations which were used in collecting primary data from the selected construction firms. The population of the study was two hundred and thirty (230) selected individuals. They consist of site supervisors (60), site engineers (60), architect (30), consultants (20) and general foremen (60) in the Tamale Metropolis of Northern Region of Ghana. Interview guide were also sent out to reach thirty (30) Project Managers of the registered Ghanaian contractors and an observations were made in six (6) different project sites to get the right information about risk and safety management in the construction industry .Stratified random and non-proportional probability sampling techniques were employed for the study. The findings of the study on factors that influence risk and safety performance revealed some important factors which include; lack of implementation of mandatory PPE policy on site, inadequate and safe means of access to and from at workplaces, difficulties in accessing risk and safety records due to restricted working conditions, and less or no lighting in confine areas on site to ensure risk and safety management. The findings of the study also gave the effects of construction sites accidents and their consequences; on fatal accidents, day’s work is suspended, construction companies pay huge sums of compensation, some accidents lead to loss of lives. The study made some recommendations which, if adopted, will lead to significant improvements in the risk and safety performance of construction companies in Ghana.

Keywords: Construction, Project Performance, construction companies, construction risk, safety management