A link between pre-morbid intelligence and all cause mortality is becoming well established, but the aetiology of the association is not understood. Less is known about links with cause specific mortality and with morbidity. The aim of this study is to examine the association between intelligence measured in adolescence and a broad range of health outcomes ascertained at 40 years of age. We use data on 7476 participants in the US National Longitudinal Survey of Youth 1979 who had their cognitive ability measured at baseline and completed the 'Health at 40' interview module between 1998 and 2004. The Health at 40 module includes assessments of general health and depression, nine medically diagnosed conditions, and 33 common health problems. Higher mental test scores were associated with lower depression scores, better general health, significantly lower odds of having five of the nine diagnosed conditions and 15 of the 33 health problems. A health disadvantage of higher cognitive ability was evident for only three of the 33 health problems.