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Rejection from the peer group may constitute an important source of stress that may weaken children's immune system and leave them vulnerable to infection and physical illness. Controlling for family adversity and depressed mood, this study examined the predictive link between peer rejection and physical health problems, as well as the putative moderating effect of adolescents' reactivity/emotional negativity in this context.A total of 122 high school students (50% girls) were assessed over two consecutive years in grades 7 (time [T] 1) and 8 (time [T] 2). More than 90% of the participants were white and French speaking and were from average socioeconomic backgrounds. Physical health problems at T1 and T2 as well as depression symptoms at T1 were assessed using adolescent self-reports. Peer rejection at T1 was assessed through peer nominations. Reactivity/negative emotionality at T1 was assessed via teacher ratings. Family adversity at T1 was assessed via mother reports.Peer rejection at T1 predicted an increase in physical health problems from T1 to T2, even when controlling for physical health problems and depression symptoms at T1. This result, however, was only true for girls with moderate or high levels of reactivity/negative emotionality. For boys, peer rejection was unrelated to change in physical health problems.The present findings are in line with the diathesis stress model of disease and emphasize the need for health education programs that specifically target girls and that foster problem-solving skills to help vulnerable adolescents cope more effectively with peer conflict.