Objectives: To investigate occupational factors associated with sick leave over a 4-year period in Australian employees. Methods: Longitudinal data (self-report) from 2861 Australian full-time employees (69.4% male) were used. Occupational factors and relevant covariates were assessed at baseline with sick leave assessed yearly over a 4-year period. The data were analyzed using multinomial logistic regression models. Results: Job strain and longer commuting time were associated with long sick leave, whereas long work hours were inversely associated with long sick leave. Conclusions: These results provide further evidence that certain aspects of work are associated with sick leave, whereas other work aspects such as long work hours are inversely associated with sick leave. Organizations need to understand and address these factors to improve the well-being of employees and increase workplace productivity.