This population-based 24-year follow-up study evaluated the association of occupational physical activity (OPA) with overweight and mortality in 47,405 men and women, healthy at baseline, and reporting OPA as sedentary (reference), light, moderately heavy, or heavy. The adjusted odds ratio for overweight was slightly less than 1 for all categories of current nonsedentary work in men but increased by OPA in women. Only heavy OPA conferred a lower mortality with an adjusted rate ratio of 0.84 (95% confidence interval, 0.76-0.92) for men and 0.69 (95% confidence interval, 0.52-0.91) for women. This observational study, with OPA recorded in the 1970s and 1980s, suggested a slight protective effect for overweight by nonsedentary work for men and lower mortality by heavy OPA for both genders. (Contains 6 tables and 1 figure.)