The building industry contributed an impressive share in Pakistan's growth sector, where the construction industry contributes almost 2.74% of the GDP of Pakistan. In most metropolitan cities, the trend of building multi-story structures is at increase. However, this construction industry is a prominent accident-prone industry where laborers generally work in an unsafe environment. These projects suffer from fatal and non-fatal accidents as labor health and security are not a prime aim in the construction industry despite all employees still dealing with safety issues. This research examines the Occupational safety and health (OSH) performance in High-rise building projects in Pakistan. This review focuses on adopting qualitative approaches, using the comprehensive literature approach for seeking current practice in health and safety and OHS laws in Pakistan's building industry. Finally, it proposes a realistic strategy for developing a safe environment at workplaces. Research indicates that Pakistan's construction sector should consider workers' safety as a priority, update and enforce safety laws at the workplace to enrich OHS conditions in the Pakistani construction sector.