By enforcement of the revised Japanese Industrial Safety and Health Law on April, 2006, the implementation of OSHMS seems to be expanding and encouraged. In OSHMS of Japan, however, the occupational health aspects have not been put into operated, while only occupational safety aspects have been prioritized. To clarify the issues to deploy OSHMS with occupational health aspects, we conducted a mail survey of 1,581 companies listed on the Tokyo Stock Market First Section in December, 2004. The effective responses were 267 (16.9%). The number of companies which had installed OSHMS, those that planned to install OSHMS and those had no plan for OSHMS were 62 (23.2%), 82 (30.7%) and 123 (46.1%), respectively. Only 12 companies include the complete OH activities in the installed OSHMS. A significant relationship was observed among expertise of OH physicians, actual role and responsibility of OH physicians, installation of OSHMS and OH services quality level. To deploy OSHMS well-balanced for health and safety aspects in present Japan, it was suggested that the education regarding OH operation in OSHMS was necessary to the person in charge of OSHMS in each company, and the participation by OH physicians to operate OSHMS, especially OH physicians with expertise, was essential.