This commentary offers a worker's perspective on agricultural health and safety and describes (1) the historical exemption of agriculture from regulatory oversight and barriers encountered due to lack of regulations and poor enforcement of the existing standards; (2) the effect of immigration status on worker protections; and (3) the basic desire for economic survival and how this impacts worker health and safety. The commentary describes two models to reduce hazards at work that illustrate how workers' perspectives can be incorporated successfully at the policy level and during the intervention development process and puts forth recommendations for employers, researchers, and funding agencies to facilitate the integration of workers' perspectives into occupational health and safety in agriculture. Ultimately, improved worker protection requires systemic policy and regulatory changes as well as strong enforcement of existing regulations. This commentary summarizes the presentation, "Ground View: Perspectives of Hired Workers," at the Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," January 27-28, 2010, Dallas/Fort Worth, Texas.