The construction work environment is characterised by significant cultural diversity (CD), which encompasses differences in language, ethnicity, religion, norms, and values. In some instances, minority groups tend to associate with specific construction trades, leading to workplaces defined by distinct functional, cultural, and linguistic territories, often demarcated by occupational boundaries. Numerous studies have underscored how these cultural differences in communication styles, norms, and other diversity-related features can foster misunderstandings and conflicts, thereby undermining health and safety outcomes in construction. Consequently, preferred reporting items for systematic reviews and meta-analyses (PRISMA) of literature be utilised for synthesising existing research to address key questions regarding the role of CD in construction health and safety. This study aims to identify the CD present on construction sites, examine its influence on health and safety performance, and explore organisational and site management strategies for effectively managing CD to enhance safety outcomes. The analysis identified diverse manifestations of CD, including differing norms, values, belief systems, languages, and behavioural patterns, as critical factors influencing both productivity and H&S outcomes. The findings demonstrate that inclusive organisational cultures that actively value and respect cultural differences are more likely to foster strong safety climates and achieve superior safety outcomes.