The purpose of social security is to ensure people's basic right to existence. In the developed countries, workers' compensation is one of the oldest types of social security system. To better comprehend the problems of the current workers' compensation system in Taiwan, we reviewed the historical development of workers' compensation systems worldwide, as well as the related conventions adopted by the International Labor Organization. In addition, we compared workers' compensation schemes in selected countries with regard to legislative framework, administrative organization, coverage of workforce, source of funds, and content and means of delivery of benefits. Based on international comparative analyses, we concluded that the problems with the workers' compensation system in Taiwan include: a complicated legislative framework with multiple laws and regulations, lack of an administrative authority specializing in workers' compensation, exclusion of some employees from the coverage, low premium rates, insufficient benefits, and inadequate coordination with the national health services and other social security systems. We suggest that changes in the legislative framework and administrative infrastructure should be the priorities in policy reform. In addition, the workers' compensation system should cover all salaried employees, incentive mechanisms for prevention should be strengthened, benefits provided should be adjusted and the benefit levels raised, and a clear line should be drawn between medical care services offered by the workers' compensation system and the National Health Insurance.