Working to ensure a safe and secure work environment for workers and employees has become an essential component of achieving organizational excellence in modern organizations. Occupational safety and health (OSH) programs help in attracting and retaining the workforce and human competencies, thus improving the operational and organizational performance of these organizations. Total quality management (TQM) is a management philosophy adopted by successful organizations to achieve sustainable business performance. This study aims to assess the level of implementation of total quality management and occupational safety and health in Saudi organizations and investigates the relationship between total quality management practices and occupational safety and health performance. Data were collected from a number of random organizations during the period November to December 2021. Based on a sample of 99 valid responses, empirical results were obtained through descriptive and advanced statistical analysis, indicating that TQM practices and OHS are highly implemented in Saudi organizations. The statistical results also showed that TQM practices have a significant positive impact on OSH performance in the surveyed organizations. The seven TQM fundamental pillars and the five OSH program components can be considered as essential success factors and fundamental pillars for TQM implementation in organizations and for OSH performance improvement.