ISSUE ADDRESSED: Job stress has been linked to a wide range of adverse effects on mental, physical, and organisational health. Despite the evidence that systems approaches are most effective in reducing the adverse impact of job stress, prevalent practice is dominated by worker- or individual-focused strategies in the absence of commensurate intervention on working conditions. METHODS: A literature review and cross-disciplinary conceptual synthesis were combined in the articulation of a systems approach to job stress. RESULTS: An outline of the job stress process is followed by explanation of how a systems approach addresses the various steps in the stress process. Systems approaches to job stress emphasise primary prevention or focusing on stressors as the upstream determinants of job stress. Additionally, systems approaches integrate primary with worker-directed secondary and illness-directed tertiary intervention, include the meaningful participation of groups targeted by intervention, and are context-sensitive. Systems approach intervention principles are illustrated by concrete examples of intervention strategies and activities. CONCLUSIONS: Further efforts are needed to promote, disseminate, implement, and evaluate systems approaches to job stress and to improve cross-disciplinary co-operation in this effort.