The impact of a comprehensive worksite health promotion program on employee absenteeism in a large metropolitan school district was evaluated. Participants in the program (n = 3,846) did not differ from nonparticipants (n = 8,290) in age or sex distributions. Program participants improved their physical fitness, body composition, coronary risk factors, and overall feeling of well-being. Absenteeism was determined for the study year and for the previous year from records in the district personnel office. Absenteeism differences were evaluated by analysis of covariance by using age, sex, ethnic group, and the previous year's absenteeism as covariates. Participants who completed the health promotion program had an average of 1.25 days less absenteeism (P less than 0.0001) during the study year than nonparticipants. Regression analyses indicated that improvement in physical fitness was associated with less absenteeism. The results suggest that a reduction in absenteeism due to the health promotion program was possibly associated with an improvement in physical fitness.