Abstract: Construction has long reputation as the riskiest workplace with frequent numbers of incidents and fatal accidents. Previously, hazard identification has drawn sufficient attention from various scholars. However, evident on identification of safety risk drivers that stimulate hazardous conditions in the construction site are still deficient. Therefore, this research aimed at exploring construction safety risk drivers and highlighting risk prevention particularly at the high-rise building construction. A total of 105 samples were gathered from the construction stakeholders in the Malaysian construction industry. Two methods were employed in this research included questionnaire survey and site observation. Data were analyzed using Exploratory Factor Analysis (EFA) with SPSS23 Software and complemented with site photograph interpretation. Twenty one risks drivers were analyzed and results from the EFA managed to rotate five principal factors namely "external drivers", "managerial drivers", "safety performance drivers", "worksite drivers" and "workforce drivers". The highest factor loading was "inadequate safety measures" which was denoted under safety performance drivers while the lowest factor loading was "economic factors" under the external drivers. A total of six factors were identified as critical risk drivers with factor loading more than (Sig. = 0.80) and were further analyzed using site observation approach based on three site profiles to complement the results of EFA. Meanwhile, sixteen factors were analyzed using EFA for risk prevention and managed to rotate two principal factors; "managerial concerns" and "safety and health requirements". These risk prevention were suggested to mitigate the occurrence and consequence of the construction safety risks. The highest factor loading for risk prevention was accounted for "safety and health induction and training" and the lowest factor loading was for "subcontractor selection and management". This research provides novelty in which the focus is on safety risk drivers and risk prevention with unique features using observation analysis to support EFA results. The finding from this research should be able to facilitate the construction practitioners to improve safety risk management in the Malaysian construction industry.