Concerns about the economic impact of an ageing population have triggered many developed countries to advance policies that attempt to extend working lives and discourage early retirement. There is considerable evidence of a relationship between poor health and early retirement, but some researchers have suggested that there is a ‘justification bias’ in claims that ill-health is the cause of retirement. This paper reports a longitudinal qualitative study that interviewed 60 New Zealanders aged between 55 and 70 years on two occasions, and analysed their explanations of health-related retirement decisions. Although the participants' explanations included poor health as an important reason for retirement, two additional health-related retirement pathways were identified: the ‘maximisation of life’, being decisions to retire whilst healthy to fulfil other life goals; and ‘health protection’, being decisions motivated by health protection and promotion. These health pathways interacted with other factors such as financial security. An elucidation of these motivations pays particular attention to the social and discursive context of explanations of retirement, and considers the three identified health-retirement pathways in relation to the sickness justification bias and current government policies to extend working lives.