Hand-arm vibration syndrome (HAVS) is a common occupational disease, which in advanced cases may be associated with significant upper extremity disability and reduced quality of life. However, HAVS is under-recognized and under-reported in Ontario and other Canadian provinces. Moreover, there is currently no legislation in Ontario for hand-arm vibration exposure. In this plenary, Dr. Ron House shares his HAVS research at St. Michael's Hospital and the Centre for Research Expertise in Occupational Disease (CREOD). He describes HAVS and its components, outlines its clinical assessment and management, and reviews the legislation for hand-arm vibration exposure and compensation experience for HAVS in Canada. He also highlights recent efforts to raise awareness of HAVS and increase focus on preventing this occupational exposure.