The aircraft ground handling is widely known as complex operations with adverse working conditions in the air transport industry. The significant growth of the industry require an extensive ground handling services to cater the demand from air traveller and cargo. The ground handling workers were overwhelmed by work and prolonged fatigue, thus leading to workplace accidents or near misses. The study aims to investigate the relationship between fatigue and safety performance outcomes of ground handling workers, and to examine whether the post-prevention control of accident/incident can change the magnitude of the relationship. A sample of 523 workers were drawn from four major ground handling companies operated at Malaysia’s international airports to participate the survey. The results indicated that were significant relationship between physical and emotional exhaustion with accidents and near misses as well as working condition and near misses, but not with accidents. The results also revealed that post-prevention control only influenced the physical and emotional exhaustion with near misses, in contrast with accidents or relationships between working condition with accidents and near misses. The study provides concrete evidence that fatigue factors are predictor to near misses and not in the case of accidents. The introduction of post-prevention control however proven to be effective with workers’ fatigue and emotional exhaustion instead of working condition of this companies. This study contributes to aircraft ground handling safety by investigating the workers’ fatigue factors, thus helping to improve the company and individual performance as well as reduce the risks related to fatigue.