Background: The working conditions in the South African public service, notably its challenging environment, pose significant threats to the physical health of employees. Calls exist in understanding how this can be addressed.Aim: The study investigated the predictors of physical health, accounting for the role of organisational climate and decent work.Setting: The study was conducted in Bisho in the Eastern Cape province of South Africa.Methods: An instrument was administered through a survey using a sample of 289 respondents. Descriptive and inferential statistics were used to test the hypothesised relationships.Results: No significant direct effect existed to show that the sounder an organisational climate, the better the physical health of employees will be (β = –0.014, t = –0.199, p = 0.843, 95% confidence interval [CI] [–0.153 to 0.125]). However, statistically significant evidence existed to show that the more focus on promoting decent work, the better the physical health of employees will be (β = 0.463, p = 0.001, 95% CI [0.258 to 0.668]). Finally, decent work has a full mediating effect on the relationship between organisational climate and employee physical health (β = 0.105, 95% CI [0.054 to 0.167]).Conclusion: Public service organisations need to pay attention to the role of its climate and decent working conditions in promoting employee physical health.Contribution: Interventions are needed centered on improving decent work and the organisational climate as identified predictors of employee physical health.