The construction industry is among the riskiest sectors worldwide due to its involvement in complex and hazardous activities, primarily because of the use of tower cranes. Tower cranes are considered the most hazardous construction machinery, contributing to a high rate of serious accidents, including fatalities and disabling injuries, not only in Vietnam but also globally. In this paper, we identify and evaluate 42 tower crane safety risk factors specific to the Vietnamese construction industry based on their probability of occurrence, severity of impact, and associated risk levels. The paper reveals that the most probable risk factor is “Unfavorable winds (including intensity, direction, etc.)” with a mean value of 3.641. The factor with the highest severity is “Wire rope is broken” with a mean value of 4.179. Furthermore, the study shows that twenty-five out of forty-two (59.52%) factors present a moderate risk level, with a Relative Significant Index Score (RSIS) ranging from 8.019 to 13.047. Among these, the factor “Bad maintenance management of the tower crane and auxiliary aids” poses the highest risk level, with an RSIS value of 13.047. This paper aims to enhance the understanding oftower crane safety among subcontractors, government safety regulators, main contractors, maintenance personnel, and workers in the Vietnamese construction industry. Additionally, the methodology presented in this paper can be adapted for assessing safety risk factors in other industries within Vietnam.