The most common injury made by ladder climbers is bruising from falling off a ladder, but bone fractures are common and head injuries are also likely, depending on the nature of the accident. Ladders can slip backwards owing to faulty base pads which usually fit into the ladder stiles. If badly worn, they can allow the aluminium to contact the ground rather than plastic or rubber, and so lower the friction with the ground. Ladder stabilisers are available that increase the ladder's grip on the ground. One of the first ladder stabilisers or ladder feet was offered in 1936 and today they are standard equipment on most large ladders.

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A ladder standoff, or stay, is a device fitted to the top of a ladder to hold it away from the wall. This enables the ladder to clear overhanging obstacles, such as the eaves of a roof, and increases the safe working height for a given length of ladder.

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It has become increasingly common to provide anchor points on buildings to which the top rung of an extension ladder can be attached, especially for activities like window cleaning, especially if a fellow worker is not available for "footing" the ladder. Footing occurs when another worker stands on the lowest rung and so provides much greater stability to the ladder when being used. The anchor point is usually a ring cemented into a slot in the brick wall to which the rungs of a ladder can be attached using rope for example, or a carabiner.

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If a leaning ladder is placed at the wrong angle, the risk of a fall is greatly increased. The safest angle for a ladder is 75.5°; if it is too shallow, the bottom of the ladder is at risk of sliding, and if it is too steep, the ladder may fall backwards. Both scenarios can cause significant injury, and are especially important in industries like construction, which require heavy use of ladders.

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The European Union and the United Kingdom established a ladder certification system – ladder classes - for any ladders manufactured or sold in Europe. The certification classes apply solely to ladders that are portable such as stepladders and extension ladders and are broken down into three types of certification. Each ladder certification is colour-coded to indicate the amount of weight the ladder is designed to hold, the certification class and its use. The colour of the safety label specifies the class and use.

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• Class 1 ladder - for heavy-duty industrial uses, maximum load of 175 kg. Colour-coded blue to identify.

• Class EN131 ladders - for commercial uses, maximum load of 150 kg. No specific colour code..

• Class III ladders - for light, domestic uses, maximum load of 125 kg. Colour-coded red to identify.

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In the UK there are a number of British standards included in the three main ladder certifications relative to the particular ladder type. Relevant classifications include BS 1129:1990 (British) which applies to Timber Ladders and Steps; BS 2037:1994 (British) which applies to Metal and Aluminium Ladders and Steps and BS EN 131:1993 (European) which applies to both Timber and Aluminium Ladders and Steps.