The purpose of this study was to examine the relationship between spousal positive social control (SPSC) and men’s health behaviors. This study also tested the mediating effect of health self-efficacy in this relationship and the moderating effects of age and relationship satisfaction (RS) in the association between SPSC and health behaviors and self-efficacy. A total of 506 unionized male workers answered a questionnaire assessing their level of health self-efficacy, how often they performed various health behaviors, and their perceptions of the frequency with which their spouse used positive social control to influence their health. Results indicated that SPSC was positively associated with health behaviors and that this association was mediated by health self-efficacy. Moderation analysis indicated that, for middle-aged and older men, SPSC was only positively associated with health self-efficacy when RS was high. Also, for older men only, when RS was low, SPSC had a backfiring effect and was negatively associated with health self-efficacy. Finally, results indicated the presence of a moderated mediation with the indirect effect of SPSC on health behaviors through health self-efficacy being moderated by age and relationship satisfaction. By indicating more precisely how, with whom, and under what circumstances SPSC can be beneficial or not, the results from this study have important implications for interventions promoting men’s health.