The Malaysian construction industry is among the highest ranked industries that contributes to accident and fatality rates. The Guidelines on Occupational Safety and Health in Construction Industry (Management) (OSHCIM) has introduced guidelines for design risk reduction in the construction industry. It involves determining root causes and mitigating the risk by control of the causation of accidents. The objective of this study is to identify the key design issues during the conceptual and detailed design review phases in the construction project. Although some of the design considerations have already been proposed by the OSCHIM guidelines, however, further implementation need to be diverse and versatile by considering the current design practices that are already being practiced by the industry practitioners. The methodology of this research involves document reviews, and a questionnaire survey that was used to collect answers from respondents in the construction industry. According to the results, the key design issues in the conceptual phase involve the site condition, environmental influences, ground or ground water condition, existing structure, demolition, services, adjacent to major infrastructure, traffic disruption, access for works, adjacent to other properties and projects, and site restriction. Moreover, those found in the detailed phase involve the mechanized construction system, installation of prefabrication components, ease of process, structural opening, edge line, fall hazard, accident prevention, layout optimization, ease of activities, permanent safety features, provision of access, and fall hazard. However, it is the duty of the construction industry practitioners to make sure that all other design issues are also included into their construction project risk analysis. As proposed by the OSHCIM guidelines, the review of design risks in the construction project should consider safety in all the stages: during construction, operation, maintenance, modification, and demolition. Construction Industry Development Board (CIDB)