Health surveillance aims at safeguard health and ensure the greatest possible protection against occupational risks and for this reason it should ensure hazard and risk control in the working environment as well as providing an appropriate detection and assessment of specific risks associated to every enterprise. The main changes in the global economy and the reorganization of services and production processes led to many changes in working life conditions and employers responsibilities, bring to the urgent need for the development and adaptation of the equipment and working methods in view of ensuring a proper protection, promotion and management of health, environment and safety issues at the corporate level. Today industrial accidents still affect significant cost in terms of not only economic but also social matters and for this reason we must emphasize the important role of occupational medicine in injury prevention through the protection and promotion of workers' health, the improvement of working and production systems, the encouragement of a "working" culture to improve the health and safety of workers in the broadest sense, both individually and collectively. Therefore, in order to prevent workplace accidents, the occupational physician should develop a methodology taking into account a whole range of factors, including the personal ones, which can be correlated to the risk to be injured planning and enacted effectiveness, efficiency, fairness and ethics interventions. Health surveillance should allow the identification of workers and/or groups of workers with the highest frequency and the greatest risk of injury, in order to direct preventive efforts in the right direction with multidisciplinary interventions through development of full cooperation not only with employers, workers and their representatives but also with other professionals may have been involved. Only through close cooperation and joint efforts of the professionals involved that you will be to reduce the number, severity and, therefore, the weight that workplace accidents have on society today.