Occupational stress is a serious threat to the health of individual workers, their families and the community at large. The settings approach to health promotion offers valuable opportunities for developing comprehensive strategies to prevent and reduce job stress. However, there is evidence that many workplace health promotion programs adopt traditional, lifestyle-oriented strategies when dealing with occupational stress, and ignore the impact that the setting itself has on the health of employees. The aim of the present study was to address two of the barriers to adopting the settings approach; namely the lack of information on how psycho-social work characteristics can influence health, and not having the confidence or knowledge to identify or address organizational-level issues. A comprehensive occupational stress audit involving qualitative and quantitative research methods was undertaken in a small- to medium-sized public sector organization in Australia. The results revealed that the work characteristics ‘social support’ and ‘job control’ accounted for large proportions of explained variance in job satisfaction and psychological health. In addition to these generic variables, several job-specific stressors were found to be predictive of the strain experienced by employees. When coupled with the results of other studies, these findings suggest that work characteristics (particularly control and support) offer valuable avenues for creating work settings that can protect and enhance employee health. The implications of the methods used to develop and complete the stress audit are also discussed.