Safety is typically cast as a trade-off with other priorities, such as production and efficiency. Such an approach sets up dramatic tension between organisational goals—an ‘either-or’ situation. Alternatively, safety can be framed as something that can be achieved simultaneously with other goals—a ‘both-and’ situation. The aim of this paper is to raise awareness of the paradoxical nature of safety and to explore how paradoxical insights might advance safety research and practices. We integrate the organisational paradox and safety literature to explore the nature of safety paradoxes and how organisations can manage them using different strategies. We then move on to discuss the implications for micro-level safety leadership and performance research. Finally, we explore the paradoxical nature of safety management in practice by highlighting emerging safety paradoxes that result from digitisation, diversification, and increasing complexity, and provide recommendations to manage them.