While religious participation is positively associated with health, and faith traditions often promote wholesome behavior among followers, religious beliefs endorsing the notion of illness as punishment for sin can be negatively related to health. To date, little is known about the correlates of this belief. This study examined demographic characteristics and religiosity as predictors of the belief that illness occurs as punishment for sin in a national probability sample of African American adults. Of 3,173 participants completing a telephone survey, 2,172 (68.45%) moderately endorsed belief in illness as punishment for sin (mean of 16 [SD=4.59] out of possible 32). Spearman correlations and linear regression modeling were conducted. Findings suggested that participants who were men, less educated, with lower income levels, lower religious beliefs, greater religious participation, greater use of negative religious coping, and both active and passive spiritual health locus of control beliefs, reported significantly stronger belief in illness as punishment for sin. Age, employment, and positive religious coping were not significant predictors. Psychologists, counselors, and health professionals working with African Americans may consider these findings in helping clients find healthy ways to reflect on their illnesses in collaboration with clergy, that are client-centered and respectful of their faith traditions.