About 67% of workers employed in the industrial and service sectors in the European Union are currently contracted by Small- and Medium-sized Enterprises (SMEs), which represent the economic heart of the European economy. However, this strength is counterbalanced by a considerably higher overall accident rate compared to Large Enterprises (LEs), and this trend seems to be confirmed worldwide. Moreover, most available tools for risk assessment and occupational health and safety (OHS) management are originally designed to fit the needs of LEs, resulting in a gap for SMEs. Therefore, the effective management of OHS in SMEs has become a crucial issue for researchers, practitioners and policymakers, aiming to improve the social and economic sustainability of small companies. The main purpose of this study is to provide guidelines to implement effective risk assessment processes and integrate them with OHS management systems in SMEs. A literature analysis of risk assessment and OHS management in SMEs highlights the main findings and gaps. Then, the three-phases methodology adopted is presented, outlining the main steps and outputs of the project. Finally, the web-based software tool for OHS risk analysis and management, designed to answer the specific needs of SMEs, is presented.