Purpose – The purpose of the paper is to investigate how health and safety gains and improvements of the construction workplace can be made through the use of three-dimensional (3D) and four-dimensional (4D) visualization technologies. Design/methodology/approach – The methodology used in the paper was a combination of semi-structured interviews with five construction project planners from three construction projects and observations of a 4D model used in one of the three projects. Findings – The findings of the paper have shown a great potential for 3D and 4D visualization in terms of communicating construction information as well as the health and safety risks in the design process where clash detection, work tasks sequence, workspace congestion can be identified by project stakeholders who are thus able to plan for alternative solutions to reduce or eliminate rework, heavy material handling and repetitive and awkward postures which expose workers to musculoskeletal injury risk. Research limitations/implications – The 3D and 4D models as they are currently used in the design of construction projects, particularly in the three projects investigated in this paper, still lack the worker reference frame and the visual interaction between the worker and the permanent as well as the temporary works. Originality/value – The paper describes the current and emerging trends in the development of 3D, virtual reality and 4D computer-aided design visualization and simulation, which have affected or are likely to have an impact on construction projects planning in the Swedish construction sector.