This paper focuses on the need to contextualise and to address the neglected occupational health and safety rights of workers in the informal economy. Informal economy workers constitute the majority of workers in most countries and the number of informally employed, unprotected and low-income workers is increasing rapidly in both developing as well as developed countries. National and international policies have not acknowledged the linkages between poverty, employment, working conditions, living environment and health inequities. Information on the scale of the problem and the health impact of worsening informal working conditions is still limited. However, the occupational health and safety hazards they face are often added to those of poor living environments, poor nutrition and unsatisfactory housing. They are not covered by social protection or comprehensive health care and besides work-related injury and disease, they are commonly affected by poverty-related diseases. The authors argue that the current context of workers’ health differs in many aspects from the past. Therefore, conventional occupational health and safety mechanisms, such as norms and good practices enforcement are insufficient to address the challenges that informal work and poor living environments poses for workers and their families. Given the nature of globalisation and urbanisation, an integrated rights-based approach of determinants at various levels and a more people-centred empowerment perspective is needed. Informal workers’ representation, organisation, participation is important for ensuring the right to health of workers in the informal economy. Social mobilisation may prove critical as it did in the past.