The current study examined the links between decent work and three components of physical health (general health, health symptoms, health behaviors) with a sample of 569 employed adults. Data were gathered at three time points over a two-month period. Drawing from Psychology of Working Theory (PWT), survival need fulfillment and workplace fatigue (Wave 2) were positioned as mediating variables between decent work (Wave 1) and physical health outcomes (Wave 3). Hypotheses were partially supported. Decent work directly, and indirectly via workplace fatigue, predicted overall physical health; decent work predicted health symptoms indirectly via workplace fatigue; and decent work predicted heath behaviors indirectly via survival need fulfillment. Findings offer a more nuanced picture of how decent work connects to physical health. Specifically, for overall health and health symptoms, workplace fatigue appears to be the main connecting variable. Individuals working in jobs considered decent may be less likely to suffer workplace fatigue, and in turn, more generally healthy with less negative health symptoms. For healthy habits, such as diet and exercise, survival need satisfaction appears more salient. Meeting one's survival needs via work may help an individual have the time, and live in the type of environment, that more allows for access to a healthy lifestyle. Implications for research and practice are discussed. •Three wave study examining the relation of decent work and physical health with a sample of 569 employed adults.•Decent work directly, and indirectly via workplace fatigue, predicted overall physical health.•Decent work predicted health symptoms indirectly via workplace fatigue.•Decent work predicted heath behaviors indirectly via survival need fulfillment.•For overall health and health symptoms, workplace fatigue appears to be the main connecting variable.