Background 270 million workplace accidents occur annually. In Uganda, Kampala district has the highest workplace injury and fatality rates. However, information on personal protective equipment (PPE)—hand gloves, hardhats, overalls, safety boots, earplugs, safety harness with lanyard, and face shields—utilization among building construction workers remains scarce. We assessed PPE utilization and determinants among building construction workers in Kampala, Uganda. Methods This cross-sectional study involved 385 respondents. Data collected by structured questionnaire was double-entered in EpiData and analyzed in STATA at 5% significance level. Independent determinants of PPE use were established by a stepwise backward logistic regression analysis. Results 305 (79.2%) respondents were males, 290 (75.3%) were 18–30 years, 285 (74.0%) completed secondary education, and 197 (51.2%) were temporary employees. 60 (15.6%) respondents used PPE. Female sex (adjusted odds ratio (AOR) = 6.64; 95% CI: 1.55–28.46; P = 0.011), temporary (AOR = 0.05; 95% CI: 0.01–0.27; P < 0.001) and casual (AOR = 0.01; 95% CI: 0.001–0.071; P < 0.001) employment, and previous knowledge of safety measures (AOR = 100.72; 95% CI: 26.00–390.16; P < 0.001) were associated with PPE use. Conclusion PPE use was low in Kampala, Uganda. Building construction companies should implement measures of the Uganda Occupational Health and Safety Act.