The construction industry in Pakistan has made a significant contribution to the country’s growth sector, accounting for approximately 2.74% of Pakistan’s GDP. The trend of construction of buildings is on the rise in most major cities. However, it is important to note that this industry is prone to accidents, as workers often operate in unsafe environments. Despite the prevalence of safety issues, the construction industry has yet to prioritize the health and safety of its labor force. The accident rates on construction sites can be primarily attributed to poor safety performance, which is influenced by several factors. In order to enhance safety performance, it is crucial to thoroughly analyze the potential factors associated with Health and safety performance. This research focuses on evaluating the significant factors that affect performance of Health and Safety in building projects of Sindh Pakistan. This study focuses on quantitative approach by using questionnaire survey forms and distributed among participants to collect the data regarding factors that affect it. The received data were analyses through Average Index (AI) method and achieved significant factors was lack of PPE availability, health and safety trainings, accident reporting mechanism, unsafe working conditions, and fall protecting system. This Studies suggest that the construction industry in Pakistan should prioritize the safety of workers by focusing on significant factors and enforcing workplace safety regulations to enhance health and safety conditions in the sector.