Behavioural approaches to safety management are commonly implemented within organizations in order to improve safety and reliability. These interventions are based upon the principle that modification and change of safety critical behaviours can facilitate safety improvements and reduce accidents. At the same time, there have been reported criticisms of behavioural approaches; specifically that they provide no substitute for a rigorously applied safety management programme and that behaviour modification is often limited to accidents with clearly identifiable behavioural precursors. Furthermore, it has been suggested (Anderson, 2005) that the focus on behavioural safety could provide a distraction from the ongoing control of low probability/high consequence risks. The current paper will identify and discuss both the advantages and limitations of behaviour-based safety interventions through reference to case studies. The sustainability of behavioural approaches will be reviewed in the context of the authors' recent review of a long-standing behavioural safety programme within a high reliability organization. The authors will seek to critically review whether behavioural safety initiatives are short-term 'fads' or provide a sustainable 'fix'.