Construction workers are at an elevated risk of heat stress, due to the strenuous nature of the work, high temperature work condition, and a changing climate. An increasing number of workers are at risk, as the industry's growth has been fueled by high demand and vast numbers of immigrant workers entering into the U.S., the Middle East and Asia to meet the demand. The risk of heat-related illnesses is increased by the fact that little to no regulations are present and/or enforced to protect these workers. This review recognizes the issues by summarizing epidemiological studies both in the U.S. and internationally. These studies have assessed the severity with which construction workers are affected by heat stress, risk factors and co-morbidities associated with heat-related illnesses in the construction industry, vulnerable populations, and efforts in implementing preventive measures.