Construction is a high-risk industry due to the high rates of accidents/fatalities recorded annually in various countries. Health and safety (HS) is a major concern of the construction industry. More so, for developing countries where HS cultures are yet to become fully established. In such situations, the perception of construction workers is a viable approach to assess the performance of HS. This study investigated the HS conditions in Saudi Arabian construction sites from the perspective of construction labor. The study employed a questionnaire comprised of 50 issues related to safety and health from an employee’s perspective, on a 1-5 Likert scale of agreement. Responses were obtained from 196 construction workers in the Eastern Province of Saudi Arabia. Results from the study showed that the crucial issues identified include: lack of communication between front-line supervisors and construction labor, less priority for safety compared to productivity; lack of employee-engagement in developing safety policies; poor morale and lack of motivation amongst workers; and un-tested emergency response procedures. Thus, the study suggests that addressing such issues will allow for improved safety performance in the Saudi Arabian construction industry.