Objective: This study reports the stress related causes of presenteeism amongst South African managers, including the opportunities and challenges of affirmative action. Methods: Data were obtained through the use of a questionnaire administered to all managers in two companies situated in the Gauteng region of South Africa. The survey incorporated the COPSOQ stress scales, Stanford Presenteeism Scale (SPS-6), and an affirmative action scale. Results: Seventy-three percent (62) of the managers responded. Cronbach’s alpha for all scales indicates adequate reliability. There were significant differences in levels of stress between South African managers and those in other countries. High levels of stress are associated with decreased presenteeism. There were significant differences in the means between black and white managers in relation to affirmative action in the South African work environment. Conclusions: Black managers appear to be alienated from feeling responsible for productivity, while white managers appear to work under fear-based motivation due to affirmative action measures imposed in the workplace.