Many south Asian countries are deficient in appropriate documentation, legislation and surveillance related to occupational health and safety (OHS). All these countries have high OHS incidence rate and labourers working in these countries are constantly exposed to occupational accidents and diseases. Although occupational accidents and work-related concerns have been in debate for a long time, no concrete moves have been taken, making situations worse and posing consistent coercions to an increasing labour force. The current research was carried out to examine the main hazards faced by construction workers in Pakistan and the response of health, safety and environment (HSE) department in plummeting these hazards and in certaining sustainability in construction companies in Pakistan. Workers working in the construction industry are incessantly bared to unsafe working conditions and have to confront several kind of hazards. This embraces exposure to sound, dust and toxic substances, issues of ergonomics, stress etc. This study employed a comprehensive fact-finding design. Data was harbored using interviews, academic articles and reports from international and national organisations. Employer, administration and labourers all lack knowledge about OHS issues in Pakistan. The majority of the labourers are unskilled, uninformed and unregistered. There are no native directives, which are coupled with both OHS and the construction industry. There is an absence of safety ethics, and neither reporting nor monitoring is conducted in the construction business. Companies see HSE issues as an economic burden which will eventually end up mounting production costs. Labourers don’t follow safety instructions; they don’t wear personal protective equipment (PPE), they reckon wearing this equipment would cause obstruction in their work and would influence their productivity. The use of PPE is essential in the construction activity, as it is considered as the last line of defence. All this has affected the construction industry tremendously collectively in terms of financial loss, human loss and image loss, and injury incidence rates have increased alarmingly. Implementation of sustainable development is a core responsibility of an HSE department. Dearth of HSE means lack of sustainability in the construction sector. Today, sustainability is an important aspect of development. It means that development should not only be economically feasable but also socially and environmentally viable both for current and future generations. There is much need to formulate new strict policy and laws or to amend old ones, laws which are effective and practical in promoting HSE and sustainability norms in the construction sector of Pakistan. The main hazards that are faced by construction workers are falling from height, lifting activity and electrocution. HSE departments play a chief role in minimizing worksite accidents and in promoting sustainable development in work settings. For ensuring sustainable practices on construction sites, HSE departments formulate integrated working policy, keeping in mind social, environmental and econmical aspects and considering inputs from all stakeholders. In addition, they look for innovative green technologies and green materials which are more environmental friendly, economical and require less energy.