Occupational Safety and Health is often poorly managed in micro-sized enterprises (MiSEs) and small and medium enterprises (SMEs). Previous studies have shown that employers in such enterprises do not conduct and/or regularly review workplace risk assessments, even though this is required by legislation. In other cases, they may conduct a superficial workplace risk assessment just to comply with legislation and satisfy the authorities. This study attempts to shed some light into the actual use or non-use of workplace risk assessment by MiSEs and SMEs, the level of its utilization, and investigate if it is used as a tool of occupational safety and health promotion and the reduction of workplace accidents and occupational diseases. It also introduces the concept of employers’ perception of the actual value of the risk assessment process. Data from ESENER-2 survey were analysed as well as data gathered by a survey conducted in Cyprus that included 201 MiSEs employing less than five employees, an area not covered by previous ESENER surveys. Analysis revealed that a significant percentage of employers in MiSEs do not perceive risk assessment as a valuable tool for improving occupational safety and health, indicating a problematic perception of and attitude towards health and safety issues. Moreover, considerable differences were identified not only in occupational safety and health management, but also in the perceived value of workplace risk assessment between northern and southern European countries, as well as for enterprises employing less than five employees.