OBJECTIVES:  Multimorbidity adversely affects health-related productivity loss. Sex may influence this relationship. This study aims to evaluate absenteeism, presenteeism and total lost productive time (LPT) due to multimorbidity from an employee perspective. METHODS:  A 2013 Partnering Healthy@Work survey of state government employees in Tasmania, Australia (N=3,228, mean age 47 years, 71.9% women) was conducted as part of an evaluation of workplace health and wellbeing programs. Multimorbidity was defined as the co-occurrence of 2+ chronic conditions out of a pre-specified list of 20. Measures of absenteeism, presenteeism and LPT were obtained from employees’ self-reported data over a 28-day period. Analyses were stratified by sex, and two-part models were used to estimate the associations between multimorbidity and productivity loss. RESULTS:  This study included 3,086 respondents. The mean age of the sample was 47 years (SD=10). The majority of the respondents were female (71.7%). The average number of health-related total LPT was 0.8 (SD=2.3) and 1.0 (SD=2.7) days for men and women with multimorbidity, respectively. Both women and men with multimorbidity had greater odds of productivity loss due to absenteeism or presenteeism compared to those without, but women with multimorbidity had 40% and 30% more LPT due to absenteeism (RR=1.4, 95%CI 1.1-1.8) and presenteeism (RR=1.3, 95%CI 1.0-1.6), respectively, in women with day lost. However, there was no significant difference in men with day lost. CONCLUSIONS:  This study identified the negative influence of multimorbidity on LPT and significant differences in LPT between men and women reporting multimorbidity. Female employees with multimorbidity were less likely to engage in their work due to presenteeism and absenteeism, and thus may require more attention in regards to planning preventive health care intervention strategies in a diverse, public sector workforce, particularly in female dominated occupations.