Absenteeism is an issue that has grown in importance over the past few years; however, little has been done to explore the impact of presenteeism on individual and organisational performance and well-being. This article is based on interviews collected in nine case study organisations in the UK. Two sector organisations (one private and one public) were studied to examine absence management and a conceptual model of presenteeism, with further illustration provided using data from the other seven case studies. This enabled a pattern of presenteeism to emerge, along with the contextual and individual factors which impact on it. In addition to previous research, we found that presenteeism is a complex ‘problem’ and that it is not a single one-dimensional construct, but is continually being shaped by individual and organisational factors. In addition, we found that performance and well-being are more closely related to the organisational reaction to presenteeism and absenteeism, rather than the act itself.