BACKGROUND The study is based on representative data and gives an overview on the extent of health inequalities in working men and women in Germany. METHODS We use data of the study German Health Update (GEDA) 2010 to analyze health differences by occupational status for men and women. Occupational Status was measured using the "International Socio-, Economic Index of Occupational Status' (ISEI). Outcomes are self-rated health status, work/and commuting accidents, self-assessed health risks at work, days with physical or emotional problems and sick leave from work. RESULTS Men and women with high occupational status are in a better health situation than those with low status in respect to all outcomes analyzed. The risk for a poor self-rated health status, high health risks at work and for the occurrence of accidents at work is significantly 2.4- to 4.6-fold (men) and 1.8- to 3.3-fold (women) increased after controlling for age and work hours. Further Analyses with regard to self-assessed health risks at work showed that occupational status differences with men and women do not differ significantly. In those analyses, about 50% of the status differences regarding risks at work could be explained for men and women by their qualification, working conditions and health behavior. CONCLUSIONS The present findings show that significant and persistent health inequalities among the employed exist in Germany. The relationship proved equally strong in both men and women.