The construction industry ranks top concerning the highest number of accidents and injuries in the global context. While there are significant advancements with regard to academic research and the evolution of organizational-based initiatives and policies to improve safety processes at job sites, implementation of such research and policies remains a challenge. Though the developed economies have relatively created a better environment concerning construction safety, developing economies are in a position to progress better. The present chapter therefore aims to discuss and address these challenges in a comprehensive manner. Theoretical advancements in the context of construction safety from accident proneness theory to behavior-based safety are discussed. Implementation of HSE management frameworks by organizations, and legal and regulatory frameworks formulated by the government and nongovernment agencies in different countries are discussed. In this context, the role of the International Organization of Standardization (ISO) is also presented. Though there is a presence of regulatory bodies and governmental intervention to regulate safety processes, existing conditions of construction safety in developing countries need further attention. These include the recording of reliable accident statistics, the need for structured safety training, the need for adequate safety infrastructure, and improving communications at job sites. Within the context of developing countries, specific HSE challenges with regard to the Indian construction sector are also elaborated. The chapter also discusses technological advancement in the context of HSE which includes the use of sensor-based technologies for identifying potential risks at job sites, the use of UAVs as effective monitoring systems, and the use of virtual reality (VR) for training construction workers and organization employees on construction safety. The chapter concludes with directions for further research in the context of construction safety for academic and industry interests.