Organizational justice perceptions are considered a predictor of health and well-being. To date, empirical evidence about whether organizational justice perceptions predict health or health predicts organizational justice perceptions is mixed. Furthermore, the processes underlying these relationships are largely unknown. In this article, we study whether bidirectional relationships can be explained by 2 different mediation mechanisms. First, based on the allostatic load model, we suggest that the relationships between organizational justice perceptions and different health indicators are mediated through mental preoccupation with work. Second, based on the affective perception and affective reaction assumption, we investigate if the relationships between different health indicators and organizational justice perceptions are mediated by social support at work. Using a large-scale Swedish panel study (N = 3,236), we test the bidirectional mediating relationships between procedural justice perceptions and self-rated health, depressive symptoms, and sickness absence with a cross-lagged design with 3 waves of data. Significant lagged effects from procedural justice to health were found for models predicting depressive symptoms and sickness absence. Mental preoccupation with work was not found to mediate the longitudinal relationship between procedural justice perceptions and indicators of health. Significant lagged effects from health indicators to procedural justice were found for models involving self-rated health, depressive symptoms, and sickness absence. Social support mediated the longitudinal relationships between all 3 health indicators and procedural justice. Results are discussed in light of previous studies and implications for theory and practice are outlined. (PsycINFO Database Record (c) 2018 APA, all rights reserved).