The zero-accident vision has sparked debate in the fields of occupational safety and health. While many organizations and policymakers have successfully implemented the zero-accident vision, numerous notable occupational safety and health scholars from various backgrounds argue against its use and success in theory and practice. This article aimed to analyze the existing literature on the variables impacting an organization’s zero-accident vision. A systematic review of the Scopus and Web of Science databases revealed 25 related studies using the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses) review method. Following a thorough review of these articles, seven main themes emerged: the occupational safety and health management system, organizational leadership, safety culture, training, communication, risk, and legislation. These seven themes resulted in a total of 28 sub-themes. Several recommendations are emphasized, including the use of a specific and standard systematic review method to guide research synthesis in the frame of reference of variables impacting the organization’s zero-accident vision and to practice complementary searching techniques, such as citation tracking, reference searching, snowballing, and contacting experts.