This study examined the relationships between the decision-making performances of soccer referees and markers of physiological load. Following baseline measurements and habituation procedures, 13 national-level male referees completed a novel Soccer Referee Simulation whilst simultaneously adjudicating on a series of video-based decision-making clips. The correctness of each decision was assessed in relation to the mean heart rate (HR), respiratory rate (RR), minute ventilation (VE), perceptions of breathlessness (RPE-B) and local muscular (RPE-M) exertion and running speeds recorded in the 10-s and 60-s preceding decisions. There was a significant association between decision-making accuracy and the mean HR (p=0.042; VC=0.272) and RR (p=0.024, VC=0.239) in the 10-s preceding decisions, with significantly more errors observed when HR≥90% of HRmax (OR, 5.39) and RR≥80% of RRpeak (OR, 3.34). Decision-making accuracy was also significantly associated with the mean running speeds performed in the 10-s (p=0.003; VC=0.320) and 60-s (p=0.016; VC=0.253) preceding decisions, with workloads of ≥250m·min-1 associated with an increased occurrence of decisional errors (OR, 3.84). Finally, there was a significant association between decision-making accuracy and RPE-B (p=0.021; VC=0.287), with a disproportionate number of errors occurring when RPE-B was rated as "very strong" to "maximal" (OR, 7.19). Collectively, the current data offer novel insights into the detrimental effects that high workloads may have upon the decision-making performances of soccer referees. Such information may be useful in designing combined physical and decision-making training programmes that prepare soccer referees for the periods of match play that prove most problematic to their decision-making.