AbstractCompetitive pressures, resource constraints, high shareholder/stakeholder expectations, and other dynamics may lead to organizations putting pressure on employees to act unethically to meet goals. Yet, the effects of this pressure on employee health and factors that can abate it are unclear. Based on the job demands‐resources model, this study examines whether, how, and when organizational ethical pressure harms employees' psychological and physical health and what factors can buffer its negative effects. According to the findings of a two‐wave lagged data study involving 212 healthcare employees, results show that organizational ethical pressure causes ethical strain in employees, resulting in both psychological and physical health problems, with these effects less pronounced when employees have higher levels of ethical efficacy. An integrated effect was also discovered, in which employees' ethical efficacy increases when led by a more ethical leader, thereby buffering the effect of ethical pressure on ethical strain and health problems. Overall, our research identifies organizational ethical pressure as a significant threat to employee health and provides preliminary approaches to mitigate its effects.