Occupational injury rates among construction workers are the highest among the major industries. While several injury control strategies have been proposed by various organisations, their effectiveness for reducing the rate of injuries in the construction industry remains uncertain. A systematic search of the literature was conducted on preventing occupational injuries among construction workers. The risk of bias of the studies was assessed and the effectiveness of interventions was evaluated. Thirteen studies were identified. In these studies, there is no evidence that introducing regulation alone is effective in preventing non-fatal and fatal injuries in construction workers. There is no evidence that regionally oriented interventions such as a safety campaign, training, inspections or the introduction of occupational health services are effective in reducing non-fatal injuries in construction workers. There is low-quality evidence that a multifaceted safety campaign and a multifaceted drug-free workplace programme at the company level are effective in reducing non-fatal injuries. Introducing regulation alone is not effective in reducing non-fatal and fatal injuries in construction workers. Additional strategies are needed to increase the compliance of employers and workers to the safety measures that are prescribed by regulation. Continuing company-oriented interventions among management and construction workers, such as a targeted safety campaign or a drug-free workplace programme, seem to have an effect in reducing injuries in the longer term. An evidence base is needed for the vast majority of technical, human factors and organisational interventions that are recommended by standard texts of safety, consultants and safety courses.