The executive physical examination has been advocated in the United States for almost 100 years. A MEDLINE search of the literature found very few studies that document the potential impact of a worksite physical examination program on medical and disability costs. Bank One has performed executive physical examinations at its corporate headquarters’ medical department since 1983. Approximately 65% of eligible executives voluntarily participate in the program annually. Medical claims and short term disability data were available for a total of 1773 executives who were eligible for a physical examination for a consecutive 3-year period. For three consecutive years after the initial physical examination, the Bank paid a total of $5361 for medical claims for periodic health examination participants (PHE) in contrast to $6426 paid for medical claims for non-periodic health examination participants (NPHE). PHE participants experienced an average 0.93 (or 2.78 for 3 years) short-term disability days absent per year in comparison with an average of 1.34 (or 4.02 for 3 years) short-term disability days absent for NPHE. The net return on investment for a worksite-based executive health examination which cost approximately $400 per executive whose total compensation (salary and benefits) is at least $125,000 is estimated to be 2.3:1, which compares favorably with other preventive health programs.