The construction industry is one of the most dangerous industry where construction workers are exposed to work-related accidents that could lead to disabilities or deaths or both of them. This research evaluates the existing safety regulations, describes safety procedures adopted by the small and medium enterprises, identifies the gaps that lead to the lower implementation of the Occupational Health and Safety (OHS) regulations and to check the awareness of such regulations by construction workers in Oman's construction industry. It also discusses the problems associated with enforcing safety regulations at construction sites. The study was conducted involving 60 participants from several ranks of small and medium enterprises. Data collection was done through questionnaire surveys and site visit observation. Although responsible bodies about occupational health and safety, owners, and contractors are all aware of the importance of safety in construction. However, field visits to construction sites demonstrate poor compliance with health regulations and legislation in the workplace. It was also observed that the problems arise due to (1) poor accident records and reporting system; (2) extensive use of unexperienced foreign labors; (3) lack of safety regulations and legislation that are specific to small and medium enterprises; (4) low implementation of occupational health and safety(OHS) regulation in small and medium enterprises; (5) low monitoring for construction fields in remote governorate (6) allow of some forbidden behaviors while working such as smoking. The research is concluded with recommendation to foster the compliance of OHS in construction such as (1) attention to safety and health before profit, (2) rehabilitation of construction entrepreneurs prior to opening these companies to take into account all the health and safety of workers before everything and to make clear plans from the beginning to prevent any accidents and injuries, and (3) periodic monitoring and inspection by the competent authorities.