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Since occupational safety and health (OSH) is considered one of the essential elements of decent work, this study measures the relationship of OSH with home based work from a gender perspective. Due to structural factors such as poverty, home based workers' health problems are neglected. Because of the gender division of labor, home based women workers are more vulnerable to chronic diseases while men are more exposed to accidents and injuries related to their occupations. Women home based workers have little access to health care due to both poverty and gender-based conceptions of family roles. Regarding reproductive health, male home based workers suffer from lacking sexual emotion while female home based workers suffer from menstruation associated problems, infertility and prolapsed uterus. Reproductive problems further create family conflict as well as self ashamedness when family expectation is not fulfilled. The OSH of home based workers should be addressed by the government through appropriate policy formulation and implementation involving all stakeholders employers, trade union leaders, health agencies, and other organizations.