The Southeast Tunisian cave dwellings of Matmata are a well-known historical model which amazingly adapt with cultural, environmental and climatic features of its surrounding. Many studies have discussed the sustainability of these dwellings but none has thoroughly discussed its performance on light of health and wellbeing of its dwellers. The WELLV1 rating system, established in 2016, is a first of a kind certification system that solely focus on the health performance of the built environment. It gives credit to designs that enhance and promote physical and psychological health of the users. The study examines the health performance of Matmata cave dwellings in the light of WELLV1 recommendations and features. The study revealed that these subterranean historical dwellings have proven good performance in relation to daylight saturation, indoor thermal relief, solar glare control, physical activity enhancement, exterior noise reduction, biophilic design and cultural enrichment. On the other hand, they lack sufficient performance in relation to air purification, social interaction, clean water supply, and altruism encouragement. Considering the scientific background, materials and technologies available for those who designed and built these dwellings, the health-related performance of their work seems unique and impressive.