The relationships of spirituality and religion to acute cardiovascular responses, physical symptoms of illness, stress and psychological mood were assessed in a community sample of adults. Nineteen men and 61 women participated in a betrayal interview, while their blood pressure and heart rate were monitored. Religious affiliation, frequency of attendance at worship and religiousness were associated with resting diastolic and mean arterial pressure. Spirituality, especially as assessed by the existential scale of the Spiritual Well-being Scale, was related to symptoms of illness, medication use, stress and negative mood states. Spirituality and involvement in organized religion may represent a means to increase the sense of purpose and meaning in life, which is related to greater resiliency and resistance to stress-related illness.