The recent accident of Mestre (northern Italy), which caused 21 fatalities due to a bus falling from a bridge, strongly highlighted the safety problem related to the presence of old railings along Italian roads. Bridge railings, also known as guardrails or parapets, serve the crucial function of preventing vehicles from accidentally driving off the edge of a bridge. Performance requirements of safety railings have been recently increased due to laws and technical standards enforced in Italy and Europe. However, many bridges along important roads, such as motorways and highways, are currently equipped with outdated safety railings since they were built before these regulations came into force. Therefore, many people are daily exposed to the risk of heavy accidents due to railing failures as well as vehicles and people eventually present below such structures. This paper aims to outline the technical problems and solutions in bridge refurbishment interventions devoted to increasing traffic safety as, for example, the installation of code-conforming railings, which often require the structural retrofit of bridge elements supporting the railing. To this end, several technical solutions are described and critically compared, and, finally, an economic analysis is reported to highlight the slab retrofit influence on the total intervention cost.