The construction sector is a key industry in the economy of the European Union (EU), with a significant impact on the Gross Domestic Product and employs approximately 30 % of the industrial workforce. Despite this positive economic impact, the construction sector suffers from high accident rates which result in significant economic costs. In 1992, the EU introduced the Directive 92/57/EEC, which aimed to establish minimum Safety and Health (S&H) requirements for construction sites. The Directive lists a number of premises that justify the need to incorporate risk prevention from the design stage of a project and to strengthen coordination throughout the project’s life. For these reasons, the Directive created the role of the Coordinators for S&H matters during the project preparation stage and execution stage, as well as the definition of a S&H Plan. The current paper analyses the state of the accident rate in the construction sector 30 years after publication of the Directive, the changes that have been made to the original text, as well as the identification of the difficulties that have been detected, both in terms of lack of definition and problems in implementation. It is possible to conclude that the management of prevention in the early stages of a project remains a persistent challenge for the industry. Additionally, it is essential to address the sector’s adaptation to the new working methods required for its transition to Construction 4.0. This discussion can serve as a valuable tool for future decision-making aimed at improving the regulatory framework.