The Malaysian construction industry continues to play a vital role in driving national economic growth. However, construction site accidents predominantly arising from the inherently hazardous nature of the construction industry that can lead to significant harm, including physical injury, death, property damage, and loss. Major causes of construction site accidents include falls, building collapse, and lack of personal protective equipment (PPE). In addition to the direct physical and financial consequences, such accidents can impact project timelines, increase costs, and damage the reputation of the involved companies. Although safety standards have been strengthened to improve site performance, construction accidents remain a persistent issue that need further investigation. This study aims to assess the effects of construction site accidents in Malaysia. A questionnaire survey has been administered to G7 contractors in Perak, with a simple random sampling method used to select participants. A quantitative approach employed to analyse the data, using the mean to assess both the frequency and impact of these accidents. The findings reveal that construction delays, damage to the company’s reputation, and additional costs to the employer are the most significant impacts of construction site accidents. These effects disrupt not only the project timeline and budget but also tarnish the company image and destroy its long-term business prospects. Delays typically result in extended project durations, while negative publicity erodes client trust and reduces future opportunities. Additionally, the financial burden on the employer increases due to added costs, such as medical expenses, legal fees, and potential fines, further complicating the project’s financial capability. The findings emphasize that construction organizations must address both the immediate financial impacts and the long-term effects on their operations and public image.