Work stress and stress-related illness have been touted as significant causes of absenteeism in the popular press. Yet, solid research evidence for a stress-absence connection is currently lacking. Methodological variation across primary studies and multiple theoretical viewpoints preclude a comprehensive understanding of the association between these two variables. The purpose of this research was to synthesize and meta-analyze accumulated findings on the topic. The theory of causation was used to explore and build hypotheses about the nature of the stress-absence relationship, including mediating processes and moderating influences. Findings from 137 studies and 275 effects provide support for a positive causal relationship between stress and absenteeism, and confirm the operation of illness mediating processes. In addition, there is evidence suggesting that absenteeism might have the potential to play a maintenance role in regulating subsequent levels of stress and illness. Little support was obtained for the underlying voluntary-involuntary distinction between frequency and time lost measures of absenteeism. Among the individual-level moderators, the influence of attribution and disposition were confirmed, while the macro social context was the only contextual moderator to receive support. Findings shed light on many theoretical viewpoints, and provide a comprehensive understanding of work stress and absenteeism.