OBJECTIVES To investigate the effectiveness of a counselling and education programme on work ability and work disability pension for employees in the construction industry. METHODS Employees with a high disability risk of 38% or more in the following four years were included. Employees in the intervention group were either selected by an occupational physician or enrolled themselves. They received an assessment and individual programme focused on optimising work functioning, while the control group received care-as-usual. Data on work ability measured with the Work Ability Index (WAI) and work disability pensions were collected at baseline during a periodic occupational health examination and at 9, 18 and 26 months after the start of the intervention using a questionnaire. RESULTS Most employees in both the intervention (n = 83) and control group (n = 209) were carpenters (43% and 37%) and bricklayers (7% and 15%). In the intervention group, 42% successfully completed the programme. Work ability in the intervention group was lower at baseline but showed an increase over time while work ability of the control group remained the same. The work ability in the intervention group improved slightly more (p = 0.09). No statistically significant differences in percentages of employees receiving a disability pension between the intervention and control group were found at 9 or 18 months and no differences in the age-adjusted percentages of employees receiving a disability pension were found between the groups at any measurement. CONCLUSIONS The programme was slightly effective in improving the work ability but not in reducing work disability pensions. A more comprehensive multidisciplinary intervention programme might be necessary.