Purpose: The goal of this project was to develop practical strategies for preventing building-related symptoms in office buildings, based on the experience of those who investigate buildings with health complaints, and suitable for use by those who own, lease, or manage office space. Design/methodology/approach: Ideas from six experienced building investigators on primary causes and key prevention strategies were gathered and prioritized through consensus and voting in a structured, multi-day workshop. Findings: IEQ investigators from diverse climatic regions agreed on the most important problems causing symptom complaints in office buildings, and the key strategies for prevention. The top ranked problems identified were, in priority order: excessive building moisture, inadequate outdoor air, excessive dust, pollutant gases and odors, inadequate thermal control, and inadequate attention by management to indoor environments. The highest priority recommended prevention strategies for building-related symptoms were: managing moisture at building exteriors, operating ventilation systems per design intent, providing at least the minimum recommended ventilation rates, and maintaining indoor temperatures at 72°F±2° (22°C±1°). Available scientific findings were generally consistent with these recommendations. Research limitations/implications: Validity of these findings, from a subjective synthesis of empirical knowledge, not from scientific research, has not yet been scientifically confirmed. Practical implications: These recommendations, including managing moisture at building exteriors, providing adequate ventilation, and controlling indoor thermal conditions, provide practical, empirically based guidelines for those who own, manage, or maintain office buildings. Originality/value: The empirical knowledge of practitioners, concentrated and synthesized here, offers more direct guidance for health-protective strategies in office buildings than current science.