The majority of accidents investigated by the US Chemical Safety and Hazards Investigation Board (CSB) occurred at smaller companies. Some of these companies do not fully recognize the hazards of the processes they operate, they are not aware of regulatory requirements, and they do not understand the value of these regulations. While small company accidents lack the visibility of large company accidents, they are devastating to the company, its employees, the community, and its customers. This article presents a brief review of some CSB investigation reports for small company accidents and summarizes the specific reasons for these accidents. I include specific recommendations for small companies and other recommendations for larger companies, regulators, and industry groups to support smaller companies in their struggle to implement process safety management (PSM). My conclusions and recommendations are based on the lessons learned from the CSB incident reports and my own personal experience that has been focused on helping small companies prevent accidents. (c) 2012 American Institute of Chemical Engineers Process Saf Prog, 2012