AbstractThe aim of this study was to explore the relationship between self‐reported job stress and job satisfaction, and the prevalence of stress‐related illnesses and risk factors among educators. A cross‐sectional survey was conducted in a representative sample of 21,307 educators from public schools in South Africa. Results indicate that the prevalence of stress‐related illnesses were 15.6 per cent for hypertension, 9.1 per cent stomach ulcer, 4.5 per cent diabetes, 3.3 per cent minor mental distress, 3.1 per cent major mental distress and 3.5 per cent asthma. The study found considerably high stress levels among educators. Job stress and lack of job satisfaction were associated with most stress‐related illnesses (hypertension, heart disease, stomach ulcer, asthma, mental distress, tobacco and alcohol misuse). From three components of the demand‐control model, two, namely work stress from teaching methods and low peer support, were related to hypertension but not to heart disease. The components of the effort‐reward model of low socio‐economic status and lack of career advancement were both not related to heart disease, and only lack of career advancement was inversely related to hypertension. Most components assessed here of the demand‐control model (including stress with teaching methods and educational system and low peer support) and effort‐reward model (including job insecurity and lack of career advancement) were related to stomach ulcer and mental distress. Copyright © 2008 John Wiley & Sons, Ltd.