We have assessed occupational risks among oil extraction workers using hygienic and medico-biological criteria. In modern oil extraction enterprises, a complex of work environment and work process factors includes occupational noise, vibration, hazardous chemicals impact, outdoor air negative indicators, work severity and intensity. Working conditions in certain occupations are characterized by a combination of predominating factors. Their intensity is of class 3 (1-4 degree) hazards. The presence of hazardous factors leads to the development of occupational and work-related diseases among workers. The highest health occupational risk level is detected in drillers, assistant drillers, operators of major, underground drill hole repairs, and machine operators. Optimization measures for occupational risk management have been developed.