Purpose The purpose of this paper is to develop an approach to compare occupational health and safety (OHS) performances of countries. Additionally, another aim is to debate the impacts of using recorded data and ratios for OHS performance evaluations. Design/methodology/approach The number of fatal accidents (NFAs), fatal accident rates (FARs), numbers of lost days (NLDs) and accident severity rates (ASRs) are determined as main criteria and six economic activity areas (EAAs) are considered as sub-criteria. Two different initial decision matrices are used as the initial decision matrix, the first of which consists of recorded data of countries related to NFAs and NLDs, and the second consists of FAR and ASR values as ratios. Importance weights of main and sub-criteria regarding the recorded data and ratios are determined using four different weighting ways. Countries are ranked via utilizing Multi-Attributive Ideal-Real Comparative Analysis considering two different initial decision matrices. Findings It can be stated that an evaluation based on ratios for comparison of OHS performance provides more realistic results. Additionally, increasing the effect of the FAR values using the 6,000 equivalent lost days factor is also important in terms of differentiating the data of the countries in question. Originality/value To the best of the authors’ knowledge, there is no study in literature that discusses the ranking of countries by means of recorded data and ratios considering different criteria. Additionally, this study is a first in terms of the number of countries evaluated and the comparison of these countries according to their respective EAAs.