Previous findings suggest that self-perception of health relates to many physical health outcomes, including mortality. Many factors appear to shape health perceptions, such as personality. Little research, however, has focused on whether personality pathology may affect perceived health. This preliminary study examined the unique effects of personality pathology on health perceptions beyond those of objective health and normal personality factors. As part of an ongoing longitudinal study, the authors examined data from a representative sample (N = 697) of St. Louis residents (ages 55-64) who were identified using standard epidemiological methods. The Diagnostic Interview Schedule and the Health Status Inventory were used to collect reports of health perceptions, chronic illnesses, and physical functioning. Personality traits were measured with the revised NEO Personality Inventory, and personality disorders were assessed using the Structured Interview for DSM-IV Personality. Number of physical illnesses, physical functioning, normal personality, and personality disorders all predicted self-perception of health separately. Personality disorders also predicted health perception above and beyond objective health and personality variables. These findings elucidate the importance of personality pathology in understanding perceived health and suggest that certain patterns of pathology may be particularly detrimental to subjective health.