This article seeks to examine the impact of technology importation on occupational health and safety in both Saudi Arabian and U.S. oil refining industries. Technologies imported to the Saudi oil industry take two forms: hardware (sophisticated equipment to run oil facilities) and software (policies and regulations pertaining to workers' health and safety, and employment rights installed by Aramco's founding multinational companies). This study utilizes qualitative, historically oriented, cross-national case studies to compare and assess workers' health, safety, and rights in Saudi Aramco with its U.S. counterpart, Motiva Enterprises. Two facilities were chosen to conduct field research: the Saudi Aramco oil refinery at Jeddah and Motiva's refinery at Port Arthur, Texas. The Jeddah refinery is fully owned by Saudi Aramco, thus, representing Aramco's health and safety policies and regulations. The Port Arthur refinery serves as a reference case study for U.S. oil refining facilities. The aspects of occupational health and safety in Saudi Aramco--ExxonMobil's joint ventures SAMREF and LUBREF--also are discussed to examine workers' health policies in both companies. The American oil industry made a significant contribution in establishing the Saudi oil industry, with the cooperation of the Saudi government. Despite having outstanding employment benefits schemes in Saudi Aramco, the presence of an organized work force better serves employee participation in Motiva than in Aramco. Safety systems such as Process Safety Management (PSM)--applied in Motiva--partially exist in Aramco to operate hardware technologies safely. Motiva training systems are better through PACE's Triangle of Prevention (TOP). Both companies follow the same pattern of handling occupational injuries and diseases; however, Saudi government agencies (GOSI) are responsible for compensating and treating injured workers. Saudi workers expressed conditional support for the worker committee program proposed by the Ministry of Labor. American and Saudi workers are concerned about the quality and sufficiency of health and safety training, employment promotion, work pressure, and job uncertainty due to continuous downsizing. This article recommends that Saudi social actors increase safety and health awareness in the work environment by providing intensive occupational safety training to the employees (as demanded by Saudi and American workers), improve labor-management relations through establishing strong cooperative contacts with regional and international trade unions, and establish uniform and standard occupational health and safety regulations for Saudi Aramco and its subsidiaries in order to provide an equal level of protection for Saudi workers.