Extensive organisational downsizing and restructuring has occurred in many countries since the 1980s. The negative consequences for workers forced into unemployment are well recognised. However, a growing body of evidence suggests there are also substantial, though less obvious, negative effects on workers who are retained. These effects may include impaired teamwork and productivity, damaged social networks and diminished social support, negative attitudes to work, elevated work-life conflict, a greater prevalence of negative health behaviours and impaired physical and psychological health. A cluster of behavioural and health effects observed amongst retained workers, described as ‘survivor syndrome’, is characterised by demoralisation, risk aversion, diminished organisational commitment and poorer health. These negative effects may be moderated to some extent by factors such as personality, gender, organisational level and age. A focus on more specific research questions and methodological refinements are likely to enhance future research in this area.