The implementation of Occupational Safety and Health Act (OSHA) at work purposed to ensure security of the safety, health and welfare of persons as well as to protect other against risks. In Malaysia, numerous actions had been undertaken in increasing the level of awareness of OSH at work, yet, studies show that occurrence of safety and health related problem are crucial. This situation posed serious inconvenience in relation to productivity and performance. Studies claims that OSH awareness are still lack, and awareness on the importance of ergonomics in the workplace, such as issues on unhealthy work environments, excessive workloads and lack of participatory ergonomic proved one of the main causes of safety and health-related problems at work. Consequently, it will lead to negative financial and non-financial performance at work. Thus, study aims to examine the relationship between ergonomic work systems (EWS) and OSH performance, in particular, workplace accident and occupational stress. This study utilised the Work System and Balance Theory to examine the relationship between the variables, hence to strengthen the development of research framework. The study was based on a sample of 40 respondents from manufacturing sector located in Penang Malaysia. Data is collected through a questionnaire distributed that has three sections, which are questions about respondents’ demography, EWS and OSH performance. The result shows that, most of workers are not aware on the issues related to workplace ergonomic. It also found that EWS were the main concern of workers that leads to workplace accident and occupational stress at work. Therefore, changes related in practicing OSH aspects at work such as altering work condition and environment, enforcing ergonomic aspects, implementing OSH training and safety culture, will help to ensure employee’s safety and health would lead to a better organisational performance in the long run.