The origin of this book is the compelling evidence that a high proportion of machinery-related deaths and injuries are attributable to genuine and serious risks originating within machine design and construction. Through a unique blending of rich empirical data coupled with safety, human factors, socio-legal and learning scholarship, Elizabeth Bluff provides both a nuanced account of firms’ performance for machinery safety, and makes conceptual and theoretical contributions to understanding and explaining their performance. These insights provide the foundations to enhance regulatory design, and the book’s conclusion recommends some innovative directions for regulatory interventions to sustain the safe design and construction of machinery.