The majority of the construction industries in Ghana are dominated by the Small and Medium Sized (SMEs) contractors. The SMEs inability to manage Occupational Health and Safety (OHS) effectiveness has been the contributing factor to the accident. A review of the literature was conducted for the development of Health and Safety (H&S) compliance model for SMEs contractors in Ghana. The study adopted various constructs from Accident Root Causes Tracing Model (ARCTM) and Domino theory. Both objective and subjective attributes were combined during the assessment. The Domino Theory form the basis for the theoretical and conceptual framework of this paper. The hypothesized H&S compliance model is presented in this paper based on an in-depth review of the previous models. The gaps identified in the literature are government support and contractor’s organizational culture. Discussions also included the integrated holistic model and the variables of the model, identification of the model and justification for the selected variables. The identified gaps serve as variable constructs in H&S compliance research. The theorized conceptual model is a multidimensional structure composed of six latent constructs.