Introduction. Abstract Background. Safety culture is a key determinant of safe medical practice, shaping healthcare personnel behavior patterns during care delivery. However, terminological polysemy, the confounding of analytical levels (artifacts, espoused values, underlying assumptions), and the lack of clear distinctions between two fundamentally opposing cultural types (blame culture versus just culture) significantly complicate strategic organizational changes in healthcare quality and patient safety management. Objective. To systematize existing definitions of safety culture, describe its structure according to Edgar Schein’s three-level model, and provide a comparative analysis of two distinct safety culture types: blame culture and just culture. Materials and Methods. A systematic review was conducted in accordance with the PRISMA guidelines, searching the PubMed, Scopus, Web of Science, and eLibrary databases for articles published between January 1980 and December 2024. A total of 29 sources were included; the core dataset comprised original research articles, while books, guidelines, and systematic reviews were utilized only in exceptional cases. Due to data heterogeneity, a quantitative meta-analysis was not performed; instead, conceptual and narrative synthesis approaches were applied. Results and discussion. Definitions of safety culture were systematized into three categories: cognitive, behavioral, and integrative. Concurrently, an original definition within Edgar Schein’s corporate culture paradigm is proposed. The three levels of culture and their respective components are defined. The essential differences between blame culture and just culture are delineated. The findings indicate that blame culture, as an inherently evolving organizational attribute, dominates most healthcare organizations, whereas a just culture remains a rare, sustainably established type that requires deliberate formation. Conclusion. Safety culture represents a strategic, measurable, and manageable construct within a healthcare organization, establishing the fundamental framework for organizational behavior. Understanding its core characteristics and structure is a prerequisite for subsequent organizational changes and development within healthcare institutions.