The study was aimed to describe the prevalence of long term sickness absence in common male and female occupations and to determine the relative importance of unemployment rates for sickness absence. The prevalence of long term sick leave was investigated among 12 male and female occupations (N = 84,319) in two counties of Sweden. The age-adjusted sickness absence rate ranged between 0.5 and 9.5% among women and between 1.2 and 9.1% in men. When controlling for age and occupation there was no relationship between unemployment rates and sickness absence rate among females. Among males, however, an inverse relationship between unemployment rates and long term sickness absence was found. An unemployment rate of 6.1% or higher was associated with a relative risk for sickness absence of 0.4 compared with reference level 1.0 in the group with the lowest unemployment rate (0-1.1%). There was a strong positive correlation between age and absenteeism. Musculoskeletal symptoms was the dominating diagnostic group in all age groups.