House alteration has grown rapidly and the process involves human activities. Investigation through observations and interviews to residences, housing contractors and neighbors at three low cost housing schemes in Shah Alam, Malaysia showed the construction activities or materials used caused problems and risk affecting social health and the environment. Despite the presence of health and safety requirements, there remains significant scope for improvement in Malaysia. These problems are related to lack of knowledge, skills and experiences in building construction. From the findings, several recommendations are made to improve the living condition for a sustainable future. A house is one of the basic human needs that also protects and act as security as identified by Maslow and Max-Neef in human theories of needs (Hadkins, 2009). However, changes in demographic and social needs of a growing family that requires more space and area, or desire for new building façade with up to-date architecture or as future property investment due to rising property values have resulted in many house owners to opt for alteration works to the existing house. People are reluctant to move out of the existing property due to increasing price of new house and materials as well as cost of relocating. Many people are still willing to stay in the same house not only because they are reluctant to move out due to the rising price and costs incurred, but many are familiar with the settings and are comfortable with the existing house and quality of life (Douglas, 2006). Alteration of existing house may involve internal and sideways extensions either horizontally and vertically or upwards. It involves many complicated construction activities. Even though the construction activities are important to the existing building industry and house owner’s needs, the activities must not compromise health, safety, productive environment and its surroundings. The main goal is that the house alteration activities should contribute to sustainable development for the existing neighborhood, communities and future generation.