The accident levels in helicopter transportation vary between geographical regions and types of operations. In this paper, we develop some hypotheses regarding the factors that may explain this variation. The aim of this paper is to improve safety in helicopter transportation through better understanding of the causes leading to fatal accidents. We provide an analysis of three segments of helicopter transportation in Norway (i.e., offshore transportation; onshore ambulance/police, and onshore transportation). This analysis refers to international research on helicopter accidents. The number of fatal accidents per million flight hours in Norwegian offshore helicopter transportation was 2.8 in 1990–1999 and zero in 2000–2015. In Norwegian onshore helicopter transportation, the fatal accident rate was 13.8 in the period 2000–2012. Twenty-three onshore helicopters crashed to the ground; seven of these crashes were fatal, killing 16 people. It is reasonable to question why there is such a significant difference in accident rates between offshore and onshore helicopter transportation. We have approached this question by comparing how the different segments of helicopter transportation are organized and managed. Our analysis shows that there are major differences both at the “sharp” end (i.e., in actual operations) and the “blunt” end (i.e., rules, regulations and organization). This includes differences in regulations, market conditions, work organization (i.e., training, employment conditions, and qualifications of the crews), operations and technology. A central argument is that differences in the market conditions and requirements stipulated by the users explain some of these differences. The same differences can be found internationally. If we use best practice and expert judgments, there is an opportunity to improve helicopter safety through improving the socio-technical system (i.e., organizational issues, improved design, improved maintenance of critical components and more focus on operational factors). A reasonable goal is that the international helicopter transportation industry could reduce the accident level to less than one fatal accident per million flight hours (Considering the oil and gas industry internationally, this would reduce the average of 24 fatalities annually to 4 per year, thus saving 20 lives each year).
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