The building construction industry in Nakuru County is one of the fastest growing industries employing a large workforce. The industry is however plagued by many health and safety problems and is sometimes rated as the most dangerous land based industry. The purpose of the research was to identify the safety and health risks in the building construction industry and determine the preventive measures used against safety and health risks. A survey was conducted and data collected using a non systematic approach using observations, questionnaires and interviews. The data was then analyzed using SPSS. It was found that there was no emphasis on health and safety issues hence many accidents and health problems occurred. This was evidenced by low use of personal protective equipment, poor or no use of scaffolds, no harnesses, lack of first aid facilities among others. There is need for the government to come up with sector specific policies for the building construction industry and strengthen enforcement. It is recommended that safety and health issues be given priority in development issues and building construction be treated like any other trade.