Purpose: While presenteeism is empirically linked to lower productivity, the role of a person's motives for engaging in presenteeism has been overlooked. Using a Conservation of Resources Theory framework, we examine the moderating effects of presenteeism motives (approach and avoidance motives) on the presenteeism–productivity relationship. Design/methodology/approach: A sample of 327 dental hygienists with chronic health conditions was surveyed. Moderated multiple regression was used to test study hypotheses. Findings: Results indicate that presenteeism does indeed appear to detriment productivity. However, we demonstrate that motives are an important moderator, such that high approach motives appear to mitigate the negative effects of presenteeism on productivity. Practical implications: Based on our findings, we suggest managers strive to improve the approach motives of their employees through processes such as job enrichment. Originality/value: This study demonstrates that presenteeism is not always detrimental to productivity, as approach motives appear to mitigate the negative effects of presenteeism on productivity. These results could drive future research on presenteeism, as well as inform best practices related to managing workers with chronic health issues.