This article suggests that theories of gender should be considered central concerning the future development of systematic occupational safety and health management in theory and practice. Despite extensive research and legislation, there are still considerable shortcomings in working conditions which indicates difficulties in the implementation of systematic occupational safety and health management. In this article, we address the need for critical analysis that complements more traditional research focusing on health or management. The overall aim is to examine and explain systematic occupational safety and health management in gender-segregated work environments in Sweden, based on theories of doing gender in work organisations. A qualitative methodological approach is used, which includes thematically analysed interviews with inspectors and managers at the Swedish Work Environment Authority. By using a gender-critical analysis several examples of how gendered norms and values complicate and constrain systematic occupational safety and health management are identified. The results pinpoint that these norms and values indirectly contribute to circumscribe essential preconditions for systematic occupational safety and health management procedures and risk leading to difficulties in creating safe and healthy work cultures.