Workplace safety is a concern for both scholars and practitioners because of the potential for substantial loss of organizational resources. The high reliability organization, and the theory that guides our understanding of this unique organizational context, contends that errors that threaten safety are systemic, dynamic workplace conditions. This paper emphasizes employees as valuable organizational assets and highlights the role of their change-oriented safety behavior in managing reliability in light of uncertain organizational environments. This paper then posits a theoretical framework that considers the relationship between forms of social support and change-oriented safety behavior in the high reliability setting, and these organizational, leader, and peer antecedents are meta-analyzed. Following an examination of 41 papers, results indicate that organizational support has the strongest relationship with change-oriented safety behavior. Such focus on the social context illustrates the complex procedures and practices of high reliability organizations, which rely on both improvisation and standardization.