Objectives: The present study sought to investigate the relationship between self-rated health, work environment and sickness absence. Material and Methods: The analysis was based on a fixed effects model (FEM). The analysis used data from Eurostat and the sixth and seventh waves of the European Working Conditions Surveys (EWCS) and European Working Conditions Telephone Survey (EWCTS). The study covered the period from 2015 to 2023. It included individuals aged 16–64 years across 24 European countries. Results: The findings have confirmed a statistically significant association between self-perceived health status and sickness absence across genders, indicating that individuals with a more favorable perception of their health were less likely to take sick leave. The analysis also confirmed the validity of creating gender-specific models. However, a statistically significant relationship between employee sickness absence costs and work-environment factors has not been confirmed across all variables. Conclusions: The study highlights the importance of self-rated health as a determinant of sickness absence and recommends further research in this area, taking into account factors related to gender, type of illness, and other socio-demographic factors, in order to improve employee health management strategies and reduce sick leave. The authors suggest that incorporating self-rated health into preventive programs and policy recommendations may help minimize sickness absence costs. Int J Occup Med Environ Health. 2026;39(5)