This report gives a critical overview of occupational safety and health (OSH) in micro and small enterprises (MSEs). It highlights not only the importance of MSEs to the economy and to society in general, but also that there are significant and well-founded concerns regarding OSH in MSEs. There is considerable evidence pointing towards a greater risk of serious injuries and fatalities in MSEs than in larger organisations. The primary reasons for this are discussed, including limitations on MSEs’ resources and where they are situated in the economy. Finally, the report also highlights significant gaps in current knowledge that, if addressed, could help improve OSH arrangements in MSEs.