South Africa has a robust legal framework to ensure that mine tailings do not become a health hazard. This notwithstanding, this article will show how a lack of effectiveness with regard to implementation and compliance has led to a situation where the health and safety of people living in communities near gold mine tailings are constantly threatened. This health hazard is exacerbated by human settlements being developed too close to mine tailings, a consequence of poor monitoring, planning and control. The authors explain how the problem could be remedied through effective implementation and compliance with the legal framework and concerted efforts between the government, mining companies and affected communities. Similarly, the establishment of exclusion zones is key to limiting exposure to pollution. At the same time, awareness campaigns will ensure that community members are equipped with the knowledge to safeguard themselves against health hazards caused by gold mine tailings.