In the 1980s, Bangladesh entered the global market by establishing export-oriented industries, the largest of which was the ready-made garment (RMG) industry. This industry has recruited a mainly female workforce consisting of millions of poor women with little formal education. Coming from mainly rural areas, they are drawn to the cities to work in the RMG factories there. This group of women has normally assumed the traditional roles of stay-at home wife, mother or daughter, hence their engagement in paid work as migrant labourers presents a new challenge in the form of their having to fulfill ‘dual roles’. Combined with workplace health and safety issues associated with the RMG industry, this can have significant implications for their physical health and mental wellbeing. Yet, it was not until the 2013 Rana Plaza incident, which killed over a thousand workers, that the world’s attention focused on the issues of health and safety of female garment workers in Bangladesh. Although the RMG industry contributes significantly to Bangladesh’s economic development, helping to raise it to the status of lower-middle-income nation, the benefits to the nation have come at a considerable cost to these women, with consequences for their physical and mental wellbeing. Regrettably, these consequences have not been adequately investigated and little data is available to fully understand their health needs and working conditions. This research aims to fill this gap by offering a more in-depth exploration of the health and safety issues as they are experienced by the women in the RMG industry in Bangladesh. It will do so by focusing on understanding their work, including the tasks, work environment, and the treatment they receive at work. It will also present and discuss women’s voices about their experience at work, incorporating key stakeholders’ views and the researcher’s own observations, in order to examine the health and safety issues of these workers through a gender lens. Using qualitative research methods, the study was conducted in four factories in two industrial areas of Dhaka district during the eight months from December 2015 to July 2016. Data collection included a literature review, 20 in-depth interviews and four focus-group discussions with female garment workers, as well as worksite and household observations. Further, 14 key-informant interviews were conducted with officials from the Ministry of Labour and Employment, health-service providers within the garment factories, factory managers, and representatives of the Bangladesh Garment Manufacturers and Exporters Association. The data collected were analyzed using a framework analysis approach. The women reported that paid work creates an opportunity for them to earn their own income, and hence improve their families’ living standards and education. However, they also reported mental and physical health issues due to the stressful nature of the work (e.g., long work hours with few breaks and sitting in one position for long hours); and the work environment (e.g., heat and dust, noise, plus poor lighting and ventilation) They are also under constant threat of losing their jobs because of their ‘slow’ work habits and in more serious cases, separation from their children, pregnancy, the double burden of work and domestic expectations, as well as the threat of physical and verbal violence in the workplace. Factories provide health services through their clinics, but these lack the proper medical facilities required to manage work-related injuries and other health conditions, especially the workers’ mental health problems caused by stress and anxiety. Workers generally do not access these limited services. In particular, pregnant workers are less likely to do so, for fear that revealing their pregnancy to their supervisors will result in a loss of employment. Further, the workers cannot easily access government hospital services, due to their long work hours. Similarly, they are blocked from using private health services because of the high costs entailed. Their employers seem focused primarily on profit and on meeting quotas in a buyer-driven market, such that the health of workers appears to be a low priority. Furthermore, this study found that the government, despite its obligations under international conventions, lacks the resources and capacity to monitor working conditions or to ensure compliance with existing labour regulations. This study found that female workers participating in paid work in the RMG industry are vulnerable to significant short- and long-term physical and mental health problems. It concludes with three sets of recommendations to (a) address the health and safety of workers, (b) build the capacity of the government’s Occupational Health and Safety (OHS) system, and (c) enlist the support of global buyers in supporting proper OHS in the RMG industry. This is important not only for the government and the industry itself, but for the whole society to recognise the important role that the female garment workers play in the national economy. As such, this study takes the position that there is an urgent necessity to improve these women’s health and safety, not just for their own sake, but also for the sustainable development of the nation.