We explored the stability of sense of coherence (SOC) and the relationship between SOC and health in two cross-lagged longitudinal samples by using structural equation modeling. In Study 1, comprising 577 municipal male and female employees, SOC was found to be stable in both sexes. In women, SOC significantly predicted sickness absences in the 4-year follow-up period. A low SOC, but not a high SOC, was associated with health prospects. Surprisingly, SOC did not influence sickness absences among men. Study 2 further tested the relationship between SOC and health in 320 male technical designers. Although SOC was cross-sectionally associated with psychological and somatic health complaints, it did not predict later health complaints in a 5-year follow-up. Thus, the present study supports the dispositional character of SOC in both sexes and its predictive validity among women. No support was found to the salutogenic status of SOC and an unexpected gender difference was revealed.