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Objective Unmet healthcare needs (UHNs) have been associated with adverse health outcomes, yet their impact on labor-related variables remains underexplored. This study examines the association between UHNs and health-related productivity loss (HRPL), work ability, and work engagement among Korean workers.Material and Methods We utilized data from the Korean Work, Sleep, and Health Study, a nationwide panel survey conducted from 2022 to 2024. UHNs were assessed based on self-reported experiences of forgoing necessary medical care. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, while work ability and work engagement were evaluated using the Work Ability Index and Utrecht Work Engagement Scale-3, respectively. Generalized estimating equation models were applied to analyze the association between UHNs and labor-related outcomes, adjusting for sociodemographic factors.Results A total of 6,633 participants were included in this study. Workers with UHNs exhibited significantly higher HRPL (mean difference, 9.517 percentage points; 95% confidence interval [CI], 8.355–10.679 percentage points) and were more likely to report poor work ability (odds ratio [OR], 3.348; 95% CI, 2.696–4.158) and low work engagement (OR, 1.506; 95% CI, 1.357–1.670) compared to those without UHNs. When participants were stratified according to the reported causes of their UHNs, similar associations were observed for both financial constraints and time constraints. However, the associations between UHNs and higher HRPL, poor work ability, and low work engagement were more pronounced when financial constraint was identified as the cause of the UHNs.Conclusion Addressing UHNs is not only a public health priority but also an economic necessity, as inadequate healthcare access can reduce workforce productivity and organizational performance. Policymakers and employers should consider integrated healthcare strategies, workplace health programs, and expanded insurance coverage to mitigate the negative consequences of UHNs on labor outcomes.Funding This work was supported by the National Research Foundation of Korea (NRF-2022R1F1A1066498).