Doctors, nurses and other health care workers in the UK are said to be increasingly aware of the ‘risks of the job’ as a result of mounting verbal abuse, threats and assaults from patients and their relatives. In the late 1990s the UK government introduced a policy of ‘zero tolerance’, which it claimed was designed to minimize the risk of such violence. Current policy refers to the need to be tough on offenders and encourage a culture of respect. In this article we review this strategy and the reasons for its introduction and consider some of the potential consequences. The article starts with an account of the policy, the definition of violence that underpins it and how it has been measured, and assesses the evidence regarding prevalence. This is then interpreted in the context of wider policies of zero tolerance to crime, and debates about risk, anxiety and insecurity.