Road construction activities are hazardous. Workers are exposed to hazards with high probability of illness, injury, disability or death. The objective was to determine road workers' perceptions of occupational hazards, ailments experienced and health seeking behaviour. This was an institution-based descriptive cross-sectional study using open-ended questions. A total of 353 road workers from Ashanti, Ahafo and Western North regions reported work-related hazards and ranked the top-3. Workers in each craft/stratum who gave consent were included in the study and interviewed. They also reported work-related ailments and health-seeking behaviour. The workers were primarily young (mean age 32.4 years) and male (97.7%). Most (70.2%) workers were contract/casual staff. 38 hazards were reported, with the top five being dust (91.5% of workers reported this), extreme temperatures (72.0%), noise (40.5%), fumes (21.8%) and vehicles/trucks (21.1%). Most (86.8%) workers reported a work-related ailment, with the most common being cough (41.1%) and headache (18.9%). Most (87.8%) workers with ailments sought treatment of any kind. Road construction workers in these regions of Ghana have good appreciation of hazards at work and the dangers they pose. Works supervisors should encourage workers on PPE use against dust, noise, fumes and good housekeeping. Regular worker-training on hazards is recommended.