Occupational health and safety continues to be a major component of the built environment. The study investigates the effectiveness of occupational health and safety laws and regulations in the construction industry in Ghana and identifies the influencing factors. Face-to-face interviews were conducted among 49 stakeholders from four relevant groups-regulatory institutions, consultants, contractors, artisans and labourers. The findings of the study suggest that the existing occupational health and safety legal and regulatory framework is barely effective. Stakeholders were aware of the existence of some laws and regulations but mostly could not identify the specific laws and their relevant contents. Consequently, compliance is found to be irregular. The key recurring factors affecting effectiveness of occupational health and safety laws and regulations include: negligence and lack of priority for occupational health and safety, lack of training, lack of funds for occupational health and safety, lack of capacity of regulatory and supervisory institutions, and lack of occupational health and safety education within construction firms. The findings of the study are foundational in strategic interventions aimed at improving compliance with occupational health and safety laws and regulations in the construction industry of Ghana.