Objective: School-teachers are exposed to high levels of stress and have high rates of premature retirement on psychiatric grounds. This study investigated factors associated with occupational disability due to psychiatric disorders in teachers in South Africa. Method: This retrospective study investigated 81 school-teachers in the Cape Town area who had been declared permanently medically disabled as a consequence of psychiatric disorders. Results: Patients were relatively young (44±6.1 yrs), had experienced symptoms for 5.2±3.8 yrs, and had been treated for 4±3.5 yrs. Almost half had a family history of psychiatric disorder, and the majority (N = 66. 81%) cited work-related stress as a significant contributing factor. Major depressive disorder was the commonest diagnosis (83%), and 56% had co-morbid Axis-I diagnoses. Thirty percent had prominent underlying obsessive-compulsive personality traits, and 46% displayed classroom phobia. Conclusion: Work-related stress is a major factor in South African teachers with occupational disability on psychiatric grounds.