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In Japan and South Korea, more than 10 million workers are employed in in small-scale enterprises (SSEs) with fewer than 50 employees. Consequently, occupational health services in SSEs are an important issue. In 1993, Japan established Regional Occupational Health Centres (ROHC as facilities for the provision of SSEs health services. In 2011 South Korea established Workers’ Health Centres (WHC, based on the Japanese ROHC model. The aim of this study is comparing occupational health services practices, to consider the quality of occupational health services in these countries. In South Korea, the data were collected by conducting interview surveys at one WHC. and the data in ROHC were collected from published materials. Those data were used to compare the two countries, both quantitatively and qualitatively. In South Korea, specialised WHC staff (including physicians occupational health nurses and others) cooperated with administrative and industry associations to develop strategic activities, based on regional diagnoses and SSE-specific needs. Also, occupational health nurses had the authority as occupational health manager. In Japan, health services were provided by the specialised staff who were registered in ROHCs (including industry physicians and occupational public health nurses. In response to a request from the SSE, health counselling and health guidance through visits were provided, but those services were not actively used among SSEs. Observed differences between ROHC and WHC were considered attributable to the presence or absence of industry physicians and authority of occupational health nurses. In Japan, it is important to strengthen the authority of occupational public health nurses, and to consider ways of addressing the occupational health needs in SSEs.