Denmark has a 39% higher rate of fatal occupational injuries within construction than Sweden. Although there are only minor differences in the work environment legislation between the countries, there may be differences in how the legislation is enforced. The aim of the study was to describe and compare the inspection practices, within the construction industry, between the Danish and Swedish Work Environment Authorities. A mixed-method approach was employed combining observations of inspections, interviews with inspectors and questionnaire responses from inspected workplaces. The primary role of both Danish and Swedish inspectors was as controllers. A minor role was as experts. A third role of being a sounding board was only identified in a few instances in Sweden. Autonomy-supportive tactics were employed more regularly in Sweden while coercive tactics were more widespread in Denmark. Negative behaviour on behalf of the inspected party was also more widespread in Denmark while positive behaviour was more widespread in Sweden. Questionnaire data revealed that the inspected Swedish companies had a significantly more positive perception of the inspectors and the benefits of the inspections. There were differences in the enforcement practices of the Danish and Swedish inspectors, which may lead to greater adherence to health and safety regulations in Sweden.