Throughout the world, construction is one of the most hazardous industries due to the complex and unsafe nature of construction; the Gaza Strip in Palestine is no exception. Construction site safety records on the Gaza strip are considered poor and local contractors, sub-contractors and their workers face daily risks from hazards that need to be managed to prevent death, injury and illness. In view of this, the aim of this paper is to provide insight into the perception of Palestinian construction managers towards: 1) the local industry's characteristics which generally affect construction safety, and 2) the factors that directly or indirectly cause site accidents. In doing so, a relative importance index was developed and used to rank the different common characteristics and factors identified by local managers. The results highlighted the most important industry characteristics that give rise to safety challenges viz.: poor accident record keeping and reporting systems; extensive use of subcontractors; and lack of safety regulations and legislation. The results also indicated that the main factors leading to site accidents are: lack of supervision and control on workers' adherence to wear personal protective equipment, lack of regular safety meetings, and the lack of respect for the few available safety regulations.