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Since 1972, workers exposed to the specific risk factors at workspace have been received annual medical check-up in Korea. The number of medical examinees has increased from 8 00 000 in 1972 to 2,000,000 in 2016 with expansion of the working population and the risk factors listed by the regulation. Recently, approximately 500 occupational physicians and 150 medical institutes are participated in this system.The risk factors have been increasing along with the new scientific findings. There were 31 kinds of risk factors that employers should provide to their employees. They increased to 122 kinds in 1999, and 177 in 2005. Since 2014, health examination to night shift workers has introduced because night shift work can be a risk factor of cardiovascular diseases, insomnia, and gastro-intestinal disorders.Recently, the diagnosis rate of occupational diseases detected by the health examination is very row (lesser than 0.1%) which is not appropriate for screening on mass medical examination. We also do not have the scientific evidence regarding effectiveness of the workers’ medical examination system for preventing of occupational diseases. However, the system has an important role of surveillance for health condition by exposure to hazardous substances and of providing occupational health services with the medical test results. Moreover, the opportunity of the annual health check-up of small sized industries is still valuable for detecting work-related diseases and life style diseases as well, which justifies the good reason for performing the periodic medical examination.The purpose of the workers’ medical examination at the beginning was not only limited to the early diagnosis of occupational diseases, but the basic information of occupational health services at workplace. The medical examination system should be amended continuously to accomplish the both purposes: early diagnosis (screening) and occupational health services (promotion).