Occupational health and safety and employee engagement literature have been studied independently. However, the need to integrate these streams of literature has now become apparent. This paper therefore seeks to address this gap by empirically testing the impact of occupational health and safety management on employee engagement in the small and medium-scaled enterprises in Ghana. A cross-sectional data from 136 employees were analysed to (dis)confirm our hypotheses. Results of the structural equation model revealed a positive effect of occupational health and safety on intellectual, social and affective engagement. However, among the dimensions of engagement, intellectual engagement was the criterion variable influenced most. The paper suggests that promoters of SMEs, owners and/or managers, should endeavour to treat the health and safety concerns of their employees with utmost priority in order to get the best out of them.