In recent years, marine pilotage accidents occurring on a worldwide basis as a result of human error have not ceased to transpire, despite advances in technology and a significant set of international conventions, regulations, and recommendations to reduce them. Existing studies reveal that previous maritime risk and safety assessment findings provide valuable insights, but over the last decade, scarce information in terms of human factor studies specific to pilotage operations can be found. The risks and uncertainties in pilotage operations have yet to be fully explored. As a result, identifying, evaluating, and mitigating the human factor-related risks influencing the safety performance of pilotage operations is essential. The aim of this research project is to investigate the effect of human factors on pilotage operations, and to evaluate the impact of these factors on operators' performance; this last in turn may affect current pilotage operations by ultimately proposing an effective risk management framework, based on a decision-making analysis methodology. Firstly, human-related risk factors (HCFs) identification is conducted through a combination of primary and secondary sourced data. A comprehensive literature review was carried out, and a considerable number of real past case examples and maritime accident/incidents investigation reports have been reviewed. In order to validate the identified risk factors (HCFs) and to explore other contributory factors, survey questionnaires and semi-structured interviews with domain experts have been conducted. An initial structural hierarchy diagram for the identified risk factors (HCFs) has been developed and validated through experienced experts belonging to the maritime sector. In order to assess the human causal factors (HCFs), a novel hybrid MCDM technique based on the combination of the Analytic Hierarchy Process (AHP) and Decision-Making Trial and Evaluation (DEMATEL) methods is applied. The AHP is firstly used to evaluate the weight and rank the importance of the identified human causal factors that affect pilotage operation safety, while the DEMATEL method is applied to determine whether there are relationships among the factors. The key findings of the previous models assist the decision-making process by informing of appropriate measures for mitigating the risks influencing pilotage operations. Risk mitigation measures are identified through literature review, the implemented regulation, rules, and recommendations adopted by IMO and other organizations and via experts’ perspectives, and then evaluated through the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). The results of this study are beneficial to the maritime industry, by means of identifying a new database on causal factors contributing to the occurrence of maritime pilotage disasters. In addition, the study provides an effective risk factors assessment tool, and offers a diagnostic instrument to help implement effective risk reduction strategies, in order to prevent or at least mitigate a human error incident/accident from occurring.