A review is made of the potential for environmental and occupational exposure to agrichemicals in South Africa. Data from the farming industry in the Western and Southern Cape regions of South Africa confirm substantial use of a range of insecticides, fungicides, and other agrichemicals. The potential for worker exposure to hazardous agrichemicals is also substantial but, to date, such exposures have been poorly characterized. Further data identify important deficiencies in industrial hygiene measures with regard to safekeeping of chemicals on farms, disposal of empty containers, use of protective equipment, and levels of safety training among farm workers. Evidence is presented for widespread underreporting of agrichemical morbidity and mortality. Surveys investigating acute health effects among farm workers with occupational exposure to agrichemicals in South Africa have produced conflicting results. The possibility of chronic health sequelae from low-dose long-term exposure is an underresearched area that is only now being investigated. A number of important obstacles to agrichemical safety are identified: the multiplicity of laws relating to pesticides administered by different departments resulting in poor coordination; the failure of existing occupational health legislation to address the agricultural workplace adequately; the unavailability and incoordination of safety training; the absence of adequate surveillance data; and inadequacies in statutory requirements with regard to waste disposal on farms. Drawing on experiences of local initiatives, possible solutions are identified that address the public health context of the problem.