Unresolved problems in South African mining, particularly on gold mines, are enmeshed within the system of production through mining methods and labour practices entrenched by apartheid. This system sets the parameters for, and hence limits and constrains, strategies designed to improve occupational health and safety. This chapter explores the achievements and limitations of statutory tripartism in mining as practiced under the Mine Health and Safety Act (MHSA), in the context of social dialogue in the National Economic and Labour Council (NEDLAC) and other statutory and non-statutory tripartite forums. The term statutory tripartism refers to the institutions and forums for social dialogue established in law. Non-statutory tripartism refers to ad hoc forums in which stakeholders deliberate on specific issues. Presented as a detailed case study in which issues are explored thematically, the chapter benefits from the experience of the lead authors in statutory mine health and safety structures. The authors reflect on the International Labour Organization’s (ILO) role to date and its future role, at a time when prospects for a broad social compact remain out of reach. While key discussions often take place outside of formally established tripartite structures, the ILO’s vision of authoritative social compacts and its institutional forms find expression in many settings. The ILO was important at critical junctures in the past and a continued role in championing social protection, inclusion and dialogue is foreseen. South Africans themselves must, however, find agreement on how best to address systemic issues. The practice of tripartism remains relevant to creating an inclusive and more equal society.