SummaryThe present meta‐analysis investigates the associations between leadership, followers' mental health, and job performance by taking into account different groups of leadership constructs including transformational leadership, relations‐oriented leadership, task‐oriented leadership, destructive leadership, and leader–member exchange. Six categories of mental health‐related outcomes are considered representing both negative and positive mental health states of followers, namely, affective symptoms, burnout, stress, well‐being, psychological functioning, and health complaints. Meta‐analytic models are used to estimate the association between these categories of leadership and mental health. Our results reveal that transformational leadership, a high quality of relations‐oriented and task‐oriented leadership behavior, as well as a high quality of leader–follower interaction are positively associated with mental health. In contrast, destructive leadership is strongly negatively associated with mental health. In addition, the mediation effects of leadership on job performance via mental health are estimated. Results partially support the mediating role of mental health concerning the relationship between leadership and job performance. Our results emphasize the importance of leadership as an occupational health factor, and they may serve as basis for the planning and designing of occupational health policies and interventions despite existing research limitations. Copyright © 2016 John Wiley & Sons, Ltd.