Aim: This study aimed to explore Australian health professionals’ perceptions and experiences regarding built environment planning for operating rooms. Methods: We conducted semi-structured interviews and a focus group using exploratory qualitative methods, involving 16 participants: anaesthetists, surgeons, nurses, theatre technicians and designers of operating rooms. Findings: Four core concerns of participants were analysed: Engagement, Respect & Collaboration; Foreseeing & Responding to Safety Concerns; Enhancing Design Planning to Minimise Internal & External Consequences; and Ambiguous Application of Standards in Operating Room Design Planning. Conclusion: Health professionals highlighted safety impacts related to patients and staff due to the built environment and emphasised the need for improved engagement, respect and collaboration in design processes. Consideration needs to be given to the lived experiences of health professionals in design planning to address safety concerns effectively. Hierarchies and cultural factors were identified as barriers to inclusive design processes.